A meta-analysis study of antimicrobial resistant E. coli in the environment.

There is increasing evidence that urban animals could play a significant role in the spread of antibiotic-resistant (AR) bacterial infections. Wild birds and pigeons have been found as carriers of multidrug-resistance Escherichia coli (E. coli) in urban ecosystems, which could threaten public health. Although AR bacteria pose challenges to healthcare systems, little is known about the prevalence and distribution of such bacteria in the environment, particularly in the built-up environment. The aim of this study was to review the literature to identify what is known so far and to identify possible animal species that should be targeted in urban environments as part of the national and international response to tackle the AR phenomenon. A systematic review was performed following the Cochrane guidelines to identify peer-reviewed articles investigating AR strains of E. coli published from January 2006 onwards. Eligible studies were selected based on inclusion criteria: carried out in urban areas in Europe; determined E. coli in isolates from urban animals by molecular methods; and results were clear and easy to extract to determine the pooled prevalence according to previous methodologies. Only 18 studies were identified as eligible and were subjected to the meta-analysis following the Cochrane recommendations. The results have highlighted that the occurrence of AR E. coli in Europe has significantly increased since 2014. The study has indicated a different occurrence of such bacteria in urban environments in Europe. Thus, higher prevalence was observed in the Netherlands, Portugal and Spain, meanwhile Latvia and Sweden had the lowest. Finally, urban avian (pigeons and gulls) and canine (domestic) species have been identified as the most likely carriers of AR E. coli in urban environments. Although these results should be considered as preliminary, special attention should be drawn to consider urban animal species in any intervention to reduce the AMR phenomenon.