Antibiotic Resistance of Campylobacter Species Isolated From Foods, Animals and Humans in Iran Through One Health Approach: A Systematic Review and Meta-Analysis.

In this study, a systematic review and meta-analysis were conducted to consider antimicrobial resistance (AMR) rates of Campylobacter in Iran. A systematic search was conducted in the databases of PubMed, Scopus and Web of Science and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data analysis was done with R software. A number of 58 articles in the current study evaluated AMR in Campylobacter species in human, animal and food isolates. Our findings demonstrated that most of the Campylobacter spp. isolates in Iran have high resistance proportions to beta-lactams (including cefixime (0.97), cephalothin (0.84), ceftriaxone (0.76), cephalexin (0.63), ceftazidime (0.53) and carbenicillin (0.38)), fluoroquinolones (including ofloxacin (0.79), nalidixic acid (0.51) and ciprofloxacin (0.52)), sulfonamides like trimethoprim-sulfamethoxazole (0.68) (potentiated sulfonamides), florfenicol (0.62), tetracycline (0.57) and macrolides (including erythromycin (0.12) and azithromycin (0.17)). Conversely, Campylobacter spp. showed low resistance rates to aminoglycosides (including neomycin (0.08), amikacin (0.08), meropenem (0.06), spectinomycin (0.04), gentamicin (0.04) and imipenem (0.02)) and chloramphenicol (0.07). Regarding Campylobacter coli and Campylobacter jejuni isolates, resistance to erythromycin (0.18-0.09), and gentamycin (0.08-0.04) was higher in C. coli than C. jejuni isolates, respectively, whereas resistance to ciprofloxacin (0.56) and tetracycline (0.56) was higher in C. jejuni. The most prevalent antimicrobial resistance genes (ARGs) in Campylobacter spp. were tetO (0.73) and cmeB (0.48) and blaOXA61 (0.42). Therefore, the use of strict control systems and a restriction on the use of antibiotics in human, agricultural and animal farming are urgently required to reduce the development and spread of AMR.