Abstract

Background: The aim of the present meta-analysis is to estimate the prevalence of colistin resistance among the Enterobacteriaceae family.Methods: Articles from various databases (Medline, Scopus, Web of Science, and Embase) examining colistin re-sistance among Enterobacteriaceae in human, animal, and environmental specimens were searched from 2016 to 2021 using related keywords. The Cochran's Q-test and I2 were applied to evaluate heterogeneity and a random -effects model was used to assess the pooled prevalence. The meta-regression method was applied to determine he-terogeneity among the studies.Results: Of 5,145 articles, 60 articles with a sample size of 404,856 was included. The pooled estimate for preva-lence of bacterial resistance were 9.13 (95 CI: 6.96 to 11.56; I-squared = 99.4) in total, 8.34 (95 CI: 5.87 to 11.16; I-squared = 99.3) for Klebsiella spp. subgroup and 3.44 (95 CI: 2.46 to 4.57; I-squared = 98.4) for E. coli subgroup. The pooled prevalence for human and animal settings were 9.07 (95 CI: 6.77 to 11.67; I -squared = 99.3) and 9.73 (95 CI: 484 to 16.02; I-squared = 99.4), respectively. The continent (coefficient: 3.51; 95 CI: 0.08 to 6.94, p: 0.045) and bacterial type (coefficient: 0.03; 95 CI: 0.01 to 0.05 p: 0.042) had signi-ficant effects on heterogeneity among studies.Conclusion: The results of this study showed that the prevalence of colistin resistance in Enterobacteriaceae was similar between animals and humans, with the highest colistin resistance found in Klebsiella strains.