Global prevalence of antimicrobial resistance in Staphylococcus spp. isolated from canine otitis externa: a systematic review and meta-analysis (1995-2024).

Antimicrobial resistance (AMR) in Staphylococcus spp. associated with canine otitis externa (COE) represents an increasing challenge for veterinary practice and public health. We conducted a systematic review and meta-analysis following PRISMA guidelines to estimate global AMR prevalence in Staphylococcus spp. from COE and to examine variation by antimicrobial class, agent, species, and continent. A literature search was conducted in four electronic databases to identify observational studies reporting antimicrobial susceptibility of Staphylococcus isolates from COE. Twenty-eight studies published between 1995 and 2024, comprising 22,864 isolates, met the inclusion criteria. Random-effects meta-analyses were performed. The overall pooled AMR prevalence among Staphylococcus spp. was 33.83% with high heterogeneity. Beta-lactams showed the highest pooled resistance (60.32%; 95% CI: 47.85,71.58), with a significant difference between methicillin resistance and third-generation cephalosporin resistance. Species-level analyses revealed significant interspecies differences for aminoglycosides and fluoroquinolones. Continent-level analysis revealed variation in specific antibiotic classes (p < 0.01), with resistance consistently peaking in South America and remaining lowest in Africa, whereas beta-lactam resistance showed striking global uniformity (p = 0.70). Meta-regression showed a significant positive association between publication year and AMR (QM = 18.95, p < 0.0001; coefficient = 0.0561 per year). In conclusion, our findings indicate that AMR among Staphylococcus spp. from COE is substantial, varies by class and species, and shows an increasing temporal trend alongside marked regional heterogeneity. These findings underscore the need for local surveillance networks, strengthened antimicrobial stewardship, standardized diagnostic protocols, and a One Health approach to mitigate AMR risks to animal and human health.