{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T18:37:08Z","timestamp":1793558228610,"version":"4.5.0"},"reference-count":99,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Carbapenem-resistant Gram-negative bacilli (CR-GNB) represent a critical threat to patients in intensive care units (ICUs), where limited therapeutic options contribute to elevated mortality. In Latin America and the Caribbean (LAC), the epidemiological burden of CR-GNB remains insufficiently characterized due to fragmented surveillance systems. This systematic review aimed to synthesize pooled prevalence estimates of CR-GNB among Gram-negative isolates recovered from ICUs across LAC countries. Methods: This systematic review was prospectively registered with PROSPERO (CRD420251177826), followed PRISMA 2020 guidelines and the JBI Manual for prevalence reviews. We searched PubMed, Scopus, LILACS, and SciELO from January 2015 to October 2025 without language restrictions. Observational studies reporting phenotypic carbapenem resistance data from ICUs in LAC countries were eligible. Two reviewers independently screened studies and extracted data. A two-level multilevel generalized linear mixed model (GLMM) with logit transformation was employed using a random-effects approach. Risk of bias was assessed using the JBI critical appraisal checklist. Results: Of 25 eligible studies spanning eight countries, 12 contributed 49 observations to quantitative synthesis. Overall pooled prevalence of CR-GNB was 28.88% (95% CI: 17.32\u201344.05%), with considerable heterogeneity (I2 = 95.24%). Species-specific prevalence was highest for Acinetobacter baumannii (72.58%), followed by Klebsiella pneumoniae (37.48%) and Pseudomonas aeruginosa (29.93%). Regional stratification revealed higher prevalence in South America (31.81%) compared to North America (22.65%) and the Caribbean (11.63%). Conclusions: Nearly one-third of Gram-negative isolates from LAC ICUs exhibit carbapenem resistance, with A. baumannii predominating. Substantial inter-study heterogeneity underscores the need for standardized regional surveillance networks and coordinated antimicrobial stewardship initiatives.<\/jats:p>","DOI":"10.3390\/antibiotics15020209","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T11:11:28Z","timestamp":1771240288000},"page":"209","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence of Carbapenem-Resistant Gram-Negative Bacilli from Intensive Care Units from Latin America and the Caribbean: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0912-490X","authenticated-orcid":false,"given":"Jes\u00fas D.","family":"Rojas","sequence":"first","affiliation":[{"name":"Programa Acad\u00e9mico de Tecnolog\u00eda M\u00e9dica en Laboratorio Cl\u00ednico y Anatom\u00eda Patol\u00f3gica, Facultad de Ciencias de la Salud, Universidad Privada Norbert Wiener, Lima 15046, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3414-3301","authenticated-orcid":false,"given":"Mercy Carolina","family":"Merejildo Vera","sequence":"additional","affiliation":[{"name":"Programa Acad\u00e9mico de Tecnolog\u00eda M\u00e9dica en Laboratorio Cl\u00ednico y Anatom\u00eda Patol\u00f3gica, Facultad de Ciencias de la Salud, Universidad Privada Norbert Wiener, Lima 15046, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7632-7593","authenticated-orcid":false,"given":"Juan Carlos","family":"Benites Azabache","sequence":"additional","affiliation":[{"name":"Programa Acad\u00e9mico de Tecnolog\u00eda M\u00e9dica en Laboratorio Cl\u00ednico y Anatom\u00eda Patol\u00f3gica, Facultad de Ciencias de la Salud, Universidad Privada Norbert Wiener, Lima 15046, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1145-8451","authenticated-orcid":false,"given":"Valeria","family":"De La Cruz Surco","sequence":"additional","affiliation":[{"name":"Programa Acad\u00e9mico de Tecnolog\u00eda M\u00e9dica en Laboratorio Cl\u00ednico y Anatom\u00eda Patol\u00f3gica, Facultad de Ciencias de la Salud, Universidad Privada Norbert Wiener, Lima 15046, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4231-9506","authenticated-orcid":false,"given":"Juan Ra\u00fal","family":"Lucas L\u00f3pez","sequence":"additional","affiliation":[{"name":"School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima 15021, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-4557","authenticated-orcid":false,"given":"Rafael","family":"Pichardo-Rodriguez","sequence":"additional","affiliation":[{"name":"Instituto de Investigaciones en Ciencias Biom\u00e9dicas (INICIB), Universidad Ricardo Palma, Lima 15039, Peru"},{"name":"Hospital de Apoyo II-2 de Sullana, Sullana 20103, Peru"},{"name":"Grupo Peruano de Evidencia Cl\u00ednica y Real-World Evidence (RpeCRWD), Sullana 20101, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global Burden of Bacterial Antimicrobial Resistance in 2019: A Systematic Analysis","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S1473-3099(25)00118-5","article-title":"The WHO Bacterial Priority Pathogens List 2024: A Prioritisation Study to Guide Research, Development, and Public Health Strategies against Antimicrobial Resistance","volume":"25","author":"Sati","year":"2025","journal-title":"Lancet Infect. 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