Global Distribution and Comparative Resistance Profiles of Escherichia coli Isolated From Bovine Meat and Meat Products: Evidence From Network Meta-Analysis.

Escherichia coli is a pivotal indicator organism for monitoring antimicrobial resistance (AMR) in the food chain. This study investigates global resistance profiles in E. coli isolates recovered from bovine meat and its derivatives employing a network meta-analysis (NMA). A Bayesian NMA was created by collating 100 studies from 41 countries that included 221,420 E. coli isolates. Resistance to 39 different antimicrobials was analyzed using the Surface Under the Cumulative Ranking Curve (SUCRA) and odds ratios (OR). Node-splitting was used to assess inconsistency between studies, and future trends were estimated using the Prophet time series forecasting method. The results of the NMA indicate that carbapenems and fourth-generation cephalosporins had the largest SUCRA values of 0.0008 and 0.1170, respectively, showing the least amount of resistance to imipenem and meropenem. Conversely, highest resistance levels were documented for penicillins (SUCRA = 0.974) and diaminopyrimidines (SUCRA = 0.908) classes, with penicillin (0.999), doxycycline (0.951), and amoxicillin (0.942). Pathogenic strains had a significantly higher proportion of resistance (32.35%) compared with commensal strains (24.09%). In addition, developing countries had nearly twice the percentage of resistance (31.73%) as did developed countries (17.03%). Estimates for resistance at the global level indicate that resistance will increase from 32% to 63.44% by 2040. The ability of widely used antimicrobials to maintain their effectiveness compared with a large number of common agricultural antimicrobials that have very high failure rates illustrates the importance of selective pressure and regulatory oversight. Strengthening of international stewardship and surveillance to prevent further spread of resistant foodborne pathogens is critical.