Assessment of the Antimicrobial Resistance Research Ecosystem in the Caribbean Region

This study assessed the antimicrobial resistance (AMR) research ecosystem across ten low and middle income Caribbean countries (CARICOM 10): Dominica, Haiti, Saint Lucia, Belize, Jamaica, Suriname, Guyana, Saint Vincent and the Grenadines, Montserrat, and Grenada.

We performed a bibliometric analysis of AMR publications for the CARICOM 10 countries from 2010 to 2025. Keyword co-occurrence mapping identified major thematic clusters. Co-citation analysis characterized the field's intellectual foundations, while co-authorship analysis assessed collaboration patterns across countries and institutions. Finally, content analysis evaluated the integration of gender and the One Health approach within AMR research.

Among 193 retrieved publications, research was heavily concentrated on a limited range of bacterial pathogens, particularly Staphylococcus aureus and Escherichia coli. Among the CARICOM 10, Haiti and Jamaica accounted for the most publications in the academic literature, with substantial co-authorship from the United States. Key thematic gaps included fungal resistance, environmental reservoirs, and broader One Health dimensions. The research ecosystem exhibited strong representation of international partners, predominantly North American and European institutions, highlighting constrained intra-Caribbean research collaboration and limited local leadership. Among the 182 articles with full-text access, only 24% incorporated gender considerations and 20% adopted a One Health approach.

The analysis of AMR research outputs from the CARICOM 10 reveals persistent gaps in geographic coverage and thematic diversity. Despite AMR recognition as a priority, the indexed literature suggests that research outputs remain shaped by extra-regional collaborations and limited local leadership. Strengthening capacity will require coordinated networks, collaboration, and integration of One Health frameworks.