A rapid systematic scoping review of the levels of bacterial antimicrobial resistance and antibiotic use amongst people in contact with the criminal justice system
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Antimicrobial resistance (AMR) poses a significant public health threat. Individuals in contact with the criminal justice system may be particularly vulnerable due to living conditions, behaviours, and pre-existing health issues. This review assesses bacterial AMR and antibiotic use in this population.
Methods
A rapid systematic scoping review was conducted (OSF: https://doi.org/10.17605/OSF.IO/XHCFJ ). Embase, Medline, and Scopus were searched for studies published between 1 January 2010 and 28 September 2023. One author screened all records, with 10% dual-screened. Included studies examined AMR bacteria or antibiotic use among people in contact with the criminal justice system. Study quality was assessed using the Newcastle-Ottawa Scale and STROBE AMS checklist. Findings were synthesized narratively.
Results
Sixteen papers met inclusion criteria; eight were at lower risk of bias. Three studies examined antibiotic use, reporting common inappropriate prescribing (n=1) and associations between recent antibiotic use and resistant infections (n=2). Fourteen papers reported AMR findings, most with a focus on Mycobacterium tuberculosis and Staphylococcus aureus . Drug-resistant TB prevalence in prison populations ranged from 5.2% to 37% (n=4). MRSA colonization ranged from 8.1% to 8.8% (n=4). Other bacteria examined included Salmonella spp ., Acinetobacter spp ., Group A Streptococcus , and Mycoplasma genitalium .
Conclusions
People in contact with the criminal justice system face heightened risks of resistant bacterial infections. However, with only three studies addressing antibiotic use, evidence is limited. Addressing AMR in this group requires collaborative and targeted public health interventions.
