Regional and temporal trends in antimicrobial susceptibility among isolates from bacterial keratitis: a systematic review and meta-analysis
Abstract
BACKGROUND: Bacterial keratitis is an important cause of preventable vision loss worldwide. In this study, we aimed to synthesise the evidence for regional and temporal differences in antimicrobial resistance that could influence the choice of empirical therapy. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, Cochrane Library, Web of Science, clinicaltrials.gov, and the WHO International Clinical Trials Registry Platform from their date of database inception to Oct 3, 2025, for studies that reported the in-vitro susceptibility of bacterial isolates from eyes with keratitis, with no restrictions on age, publication date, or language. We excluded animal studies, single case reports, reviews, conference proceedings, editorials, grey literature, unpublished studies, and studies with an incomplete description of the anatomical source of the samples or samples collected from the conjunctiva. We excluded studies that recruited exclusively from settings such as intensive care or only included individuals with specific syndromes or other disease groups. Except for meticillin-resistant Staphylococcus aureus, studies that only reported resistant or multiresistant bacterial isolates were excluded. We contacted study authors for further information, as required. We pooled data using a random-effects meta-analysis of proportions and examined susceptibility by Global Burden of Disease super region and changes over time. The main outcome was the…
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