DOI: 10.1177/11786302261455135 ISSN: 1178-6302
A Systematic Review and Meta-Analysis of the Prevalence and Antibiotic Resistance Patterns of
Campylobacter
Species in Low- and Middle-Income Countries: A One-Health Perspective
Aaron Awere-Duodu, Frederick Kungu, Eric S. Donkor
Background
Campylobacter
infections are increasing globally, with an estimated 400-500 million cases recorded annually. Low- and middle-income countries (LMICs) conditions facilitate the transmission of these pathogens between humans and animals, contributing to the global increase in infections. This systematic review and meta-analysis assessed the prevalence and antimicrobial resistance patterns of
Campylobacter
species in LMICs from the One-Health perspective.
Methodology
Comprehensive literature searches were conducted in PubMed, SCOPUS, and Web of Science. A total of 530 retrieved articles were screened using a predefined selection criterion. Prevalence and resistance meta-analyses were conducted by subjecting the extracted data to the random-effects model in RStudio version 4.4.2. Meta-regression and sensitivity analysis were conducted to assess the moderators of heterogeneity and robustness of included studies, respectively.
Results
A total of 130 articles were included in this study. The prevalence of
Campylobacter
species was highest in animals (14.76% [12.44; 17.25]), followed by the environment (10.95% [6.93; 16.47]) and humans (10.34% [7.41; 13.68]). The most prevalent species were
C. jejuni
,
C. coli
, and
C. upsaliensis
in all three sample sources. Lower-middle-income economies had the highest prevalence, followed by upper-middle-income economies and low-income economies. Generally, all
Campylobacter
spp. showed high resistance to tetracycline (66.82% [62.10; 71.40]), nalidixic acid (65.18% [59.12; 71.03]), and ciprofloxacin (62.52% [57.20; 67.71]). Additionally, there was a 60.65% [53.78; 67.32] prevalence of multidrug resistance (MDR), followed by extensive drug resistance (XDR) with 55.14% [29.74; 79.21] and pan-drug resistance (PDR) with 1.68% [0.57; 3.23].
Conclusion
There is a higher prevalence of
Campylobacter
species in animals compared to humans and the environment in LMICs, coupled with a high prevalence of multidrug resistance. Hence, stricter monitoring and regulation of antibiotic use in animal farming and humans are required to curb the increasing antibiotic resistance.