The Global Burden of Antimicrobial Resistance in Cancer Patients: A Systematic Review
Abstract
Abstract Background Antimicrobial resistance (AMR) is a significant global threat to cancer care, especially for immunocompromised patients who face higher risks of infection-related morbidity and mortality. This systematic review compiles data on bacterial pathogens from cancer patients, their antimicrobial susceptibility patterns, and related clinical outcomes from six continents and 39 countries. Methods A comprehensive analysis of 50 peer-reviewed studies from 2014 to 2025 was conducted, selected from 8,294 records through rigorous PRISMA-guided screening. Studies included prospective cohorts (n = 15), retrospective cohorts (n = 18), cross-sectional analyses (n = 8), and systematic reviews (n = 9) examining bacterial infections in hematologic malignancies and solid-tumor malignancies. Results Gram-negative bacteria predominated across all continents except the Americas, where Gram-positive organisms were more prevalent. Escherichia coli was the most frequently isolated pathogen globally (12–50%), followed by Klebsiella pneumoniae (7.9–47.1%), Pseudomonas aeruginosa (3.2–29.5%), and Acinetobacter baumannii (4.8–18.2%). Carbapenem resistance reached alarming levels in Africa (36–57%), Asia (12.2–32.8%), and the Middle East (20–30%), while remaining relatively low in Europe (0.5-5%) and North America (2–5%). ESBL production was documented in 41–85% of Enterobacteriaceae in African studies compared to 2–15% in European cohorts. MRSA prevalence ranged from 9.7% (China) to 75%…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 18 participants or records.
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