Global spread and antimicrobial resistance of Aeromonas hydrophila in aquatic food animals: a systematic review and meta-analysis

Abstract Aeromonas hydrophila is a common zoonotic agent in aquatic environments that causes gastroenteritis and wound infections in both humans and animals through foodborne and hospital-acquired infection. Antimicrobial resistance (AMR) combination with virulence factors enhances treatment challenging. The prevalence and AMR of Aeromonas hydrophila have been increasingly reported, posing a significant threat to both animal and public health. This systematic review and meta-analysis aimed to determine the prevalence of A. hydrophila and its resistance to aquatic food animals. A comprehensive search for relevant studies was conducted on Google Scholar, PubMed, ScienceDirect, and Scopus, following the PRISMA guidelines, covering studies from January 2020 to December 2024. The quality of the included publications was evaluated using the Joanna Briggs Institute critical appraisal tool. Differences in the prevalence and AMR of A. hydrophila were assessed using a random-effect model. A total of 14,077 studies were screened, and 14 publications were included. Bacterial isolation of A. hydrophila was achieved using various standard protocols, involving culture on Rimler-Shotts (RS) agar and Tryptic Soy Agar (TSA), with or without antimicrobials. Subsequent biochemical identification confirmed the isolates. The pool prevalence of A. hydrophila (30.7%, 95% C.I.:17.0-46.3%), and the distribution of virulence genes were 71.2%. The most common resistance observed to penicillin (80.7%), oxytetracycline (69.9%) and macrolides (67.8%). The most prevalent AMR genes identified were bla TEM (67.0%), followed by tetA (63.7%). The increasing presence of A. hydrophila in aquaculture suggests a considerable risk of disease. The prevalence of both A. hydrophila and AMR was higher in Africa than in Asia, indicating regional variations in the AMR pattern. However, monitoring and surveillance of A. hydrophila remained limited. A major limitation of this study was the heterogeneity in effect estimates across the selected studies. Nonetheless, the quality assessment conducted indicated that this variability did not compromise the consistency or reliability of the findings.