Wastewater surveillance of antimicrobial resistance in human populations: an updated systematic review and meta-analysis of the concordance between wastewater and human resistance prevalence — protocol v1.0 and search strategies as executed (PROSPERO CRD420261520110)

Full protocol (PRISMA-P 2015) and search strategies as executed (PRISMA-S) for an updated systematic review and meta-analysis of the concordance between antimicrobial resistance (AMR) prevalence measured in wastewater and in human populations, extending Chau et al. 2022 (Environ Int 162:107171; PROSPERO CRD42019134946) to studies published from 1 January 2021, with extensions to genomic detection methods and low- and middle-income settings. Primary outcome: Lin's concordance correlation coefficient per organism-antimicrobial/gene comparison. Registered on PROSPERO as CRD420261520110 (published 11 October 2026). Deposited before title/abstract screening began. Contents: protocol v1.0 with a dated amendment log of all pre-screening changes; every database search string as executed on 16-18 October 2026 (PubMed/MEDLINE, Scopus, Embase, Web of Science Core Collection and Preprint Citation Index, CAB Abstracts, Global Health) with dates, limits, hit counts and export checksums; forward citation tracking of the 34 seed studies; grey-literature sources; the title/abstract screening rubric and SOP; deterministic deduplication code and logs; and the known-item test against the 33 studies included by Chau et al. Searches identified 20,403 database records (7,059 unique) plus 1,506 new records from citation tracking: 8,565 records to title/abstract screening. Raw licensed database exports are not redistributed; their checksums are given. Screening decisions, the extraction dataset and analysis code will be deposited as a separate record at manuscript submission. AI use: a large-language-model assistant (Claude, Anthropic) was used under the guarantor's direction for drafting, operating database interfaces with the account holder signed in, deduplication code, and a non-deciding third title/abstract rating; all eligibility decisions are made by two human reviewers. Where this deposit and the PROSPERO record differ, the PROSPERO record is binding; differences are listed in the protocol's Appendix A. Version 1.1 will add the PRESS-reviewed search strategy; version 2.0 (at submission) adds the screening log, extraction dataset, risk-of-bias table and analysis code.