Systematic review and meta-analysis of antimicrobial resistant bacteria in free-ranging wild mammals.

BACKGROUND

Bacterial antimicrobial resistance is a significant global threat to public health, closely linked to the misuse of antimicrobials in human and veterinary medicine, aquaculture, and agriculture. The consequences of antimicrobial resistance overcome species boundaries and require a holistic approach for mitigation actions. The study of antimicrobial resistance in wildlife is thus increasingly relevant to understand the spread of antimicrobial resistance in the environment and the animal community, as well as to investigate the role of wildlife either as a carrier, reservoir, spillover, or indicator of antimicrobial resistance. The aim of this study is to describe the prevalence and type of antimicrobial resistance in bacterial isolates from wild mammals through systematic review and meta-analysis of the available literature, following the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines.

RESULTS

Out of 5052 collected documents, 3795 were screened, and finally 139 studies on antimicrobial resistance in free-ranging wild mammals were included in the meta-analysis. The studies covered 37 countries, mostly European. The Enterobacterales Escherichia coli and Salmonella spp., as well as Campylobacter spp., were the most frequently targeted bacterial species, mainly in the Artiodactyla order and specifically in the Suidae and Cervidae families. Low to moderate prevalences of antimicrobial resistance were found in all the continents, countries, bacteria, host taxa, and antimicrobials included in the meta-analysis, even for critically important antimicrobials as defined by the World Health Organisation, with higher values in Africa and Asia, in carnivores, and in animal species with high adaptability to diverse habitats.

CONCLUSION

This meta-analysis showed that antimicrobial resistance in wild mammals is widespread and variable according to taxonomy, trophic source, and geographic location. The meta-analysis highlighted methodological gaps that need to be addressed to improve the interpretation and conclusions obtained from the data. Genetic analyses on antimicrobial resistance and population ecological data should be included in future analysis to achieve a standardised methodology and overcome current limitations. To date, wildlife appears to be an environmental indicator of antimicrobial resistance and should be included in antimicrobial resistance surveillance plans not only because this sentinel role but also to monitor potential spill-back to livestock and/or humans.