Emerging pathogen alert: Global epidemiology of the zoonotic potential of Escherichia albertii: A systematic review and meta-analysis.

Escherichia albertii (E. albertii) is a globally emerging zoonotic foodborne pathogen with underestimated public health significance due to misidentification challenges. This study systematically investigated the global epidemiology and host spectrum of E. albertii through a meta-analysis of its prevalence and associated epidemiological determinants across different sources. A total of 13 studies published between 2000 and 2025 were identified through comprehensive searches of Scopus, Web of Science, and PubMed, which were based on predefined inclusion criteria. The data were systematically extracted using Microsoft Excel, and the statistical analyses were performed in R (v4.5.0). To address substantial heterogeneity, a random effects model was applied to estimate the pooled prevalence. The meta-analysis included 13 studies comprising 5439 samples, 454 of which 454 were positive for E. albertii, resulting in a pooled prevalence of 15.49 % with significant heterogeneity (97 %). Subgroup differences by country (τ2 = 0.0008-0.0249), host (τ2 = 0.0032-0.1031), and sample (τ2 = 0.0076-0.0881) were statistically significant (p < 0.0001), whereas meta-regression identified no significant covariates. The highest prevalence was observed in Bangladesh (63.93 %), whereas the lowest was in Belgium (1.35 %). Host-specific analysis revealed the highest prevalence in chickens (26.75 %) and raccoons (25.61 %), whereas that in oysters (2.11 %) was the lowest. Meat (17.95 %) and fecal (17.43 %) samples presented the highest pooled prevalence among the samples. This study suggests that E. albertii is globally distributed and may exhibit underrecognized host diversity, highlighting its potentially underrecognized importance for public health. However, given the limited number of studies and substantial heterogeneity, these findings should be interpreted with caution.