title: Refugees and antimicrobial resistance: A systematic review.
abstract: BACKGROUND
  There is a large increase in the numbers of refugees and asylum seekers worldwide and a lack of data on the carriage of antimicrobial resistance in refugee/asylum seeking groups.
  
  
  METHODS
  This article aims to identify the impact of refugees and asylum seekers on the acquisition and transmission of antimicrobial resistance (AMR) through a literature search. The databases Embase, Medline, Pubmed, and Web of Science Core Collection were utilised and covered all articles before the 1st of October 2016. In total, 577 articles were identified, and studies were eligible if they met the selection criteria, including observational study design, English language, and AMR strains reported in absolute numbers. In total, 17 articles met the criteria, the majority were from the European region.
  
  
  RESULTS
  Articles fitting the selection criteria exclusively reported AMR in bacterial species including Mycobacterium tuberculosis, Escherichia coli, Klebsiella pneumonia, K. oxytoca, Shigella spp., Staphylococcus aureus, Enterococcus faecium, and Acinetobacter baumannii. The analyses indicated that a high percentage of AMR strains, have been circulating among refugees and asylum seekers.
  
  
  CONCLUSIONS
  The displacement of refugees and asylum seekers seem to play a key role in the transmission of AMR. Therefore, improved AMR control measures are essential. A knowledge gap was identified; further research is strongly recommended.
authors.affiliation: School of Public Health, The University of Sydney, Sydney, Australia.
authors.forename: Allard Willem
authors.initials: AW
authors.lastname: de Smalen
authors.affiliation: School of Public Health, The University of Sydney, Sydney, Australia.
authors.forename: Hatem
authors.initials: H
authors.lastname: Ghorab
authors.affiliation: The Westmead Institute for Medical Research, The University of Sydney, Sydney, Australia; The Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia. Electronic address: moataz.mohamed@sydney.edu.au.
authors.forename: Moataz
authors.initials: M
authors.lastname: Abd El Ghany
authors.affiliation: School of Public Health, The University of Sydney, Sydney, Australia; The Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.
authors.forename: Grant A
authors.initials: GA
authors.lastname: Hill-Cawthorne
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects*; D001424:Bacterial Infections / Q000382:microbiology* / Q000517:prevention & control / Q000635:transmission; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000187:drug effects; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D012036:Refugees; D013211:Staphylococcus aureus / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents
keywords: Antimicrobial resistance (AMR); Asylum seeker; Multidrug resistance (MDR); Refugee