Data Challenge: Antimicrobial Susceptibility Patterns of Gram-Positive Cocci Isolated from Intensive Care Unit Patients in African Countries: An ATLAS Database Analysis (2016-2024)

Gram-positive cocci, including Staphylococcus aureus and Enterococcus species, are leading causes of intensive care unit (ICU)-acquired infections. In African countries, rising methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) threaten last-line therapies. However, comprehensive data on resistance patterns, temporal trends, and multidrug resistance (MDR) across African ICUs remain scarce. Therefore, this study aims to describe antimicrobial resistance (AMR) patterns, determine resistance trends from 2016 to 2024, and estimate the prevalence of MRSA, VRE, and MDR among Gram-positive cocci isolated from ICU patients in African countries using the ATLAS database. We will analyze all Gram-positive coccus isolates from ICU settings reported to ATLAS by African countries over the study period (2016–2024). AMR patterns to key antibiotics, including MRSA and VRE, will be determined based on CLSI and EUCAST guidelines. Annual and regional trends will be analyzed using a trend analysis (Joinpoint or logistic regression). MDR is defined as non-susceptibility to at least one agent in three or more antibiotic classes. Data will be stratified by pathogen, specimen type, and geographic region. We will produce a multi-country, longitudinal snapshot of AMR patterns of Gram-positive cocci in ICU patients across Africa. Findings will inform empirical antibiotic guidelines for African ICUs, antimicrobial stewardship priorities, and laboratory capacity strengthening for antimicrobial susceptibility testing.