Fluoroquinolone Resistance in Campylobacter Isolates from Broiler Meat: A Systematic Review and Meta-Analysis at a Global Scale

Campylobacter spp. and antimicrobial resistance (AMR) pose global public health threats. Approximately nine million cases of illness per year are attributed to Campylobacter, mainly associated with broiler meat consumption. Furthermore, nearly five million deaths annually are attributed to the ‘silent pandemic’ of AMR. Considering this, the exposure to resistant Campylobacter spp. represents a global concern to be addressed. This systematic review and meta-analysis aim to estimate the prevalence of fluoroquinolone-resistant Campylobacter in broiler meat at the retail level. A comprehensive systematic review was conducted following the PRISMA protocol by mapping fluoroquinolone-resistant Campylobacter from broilers. The review covers the period from 2003 to 2024 without geographical restrictions. Data regarding Campylobacter species, processing stage (retail, processing plant, slaughterhouse), and the matrix (meat, skin, or mixed) were extracted. In addition to systematic review, we conducted meta-analyses to compare the pooled AMR prevalence by continents and other variables. Over half of the tested Campylobacter isolates at the retail level are fluoroquinolone- resistant, with considerable differences across regions. The highest values were from South and Central America (CIP 79%; NAL 85%) and North Africa (CIP 74%; NAL 96%), while the lowest value was observed in North America (CIP 15%; NAL 26%) and Oceania (CIP 11%; NAL 13%). In Europe, a clear trend for resistance rise was observed in the study period. Harmonizing sample collection, analysis, and reporting across the scientific community is recommended to enhance data comparability and reduce uncertainties for risk assessments and epidemiological studies. Harmonizing methodologies and reporting of results in scientific communities is strongly recommended.Over half of the Campylobacter spp. isolated from broiler meat at the retail level were resistant to fluoroquinolones.The pooled prevalence for ciprofloxacin was 60% (95% CI, 55–65), for nalidixic acid 65% (95% CI, 59–70), for enrofloxacin 56% (95% CI, 43–68), for ofloxacin 54% (95% CI, 32–75) and for levofloxacin 63% (95% CI, 21–96).There are noticeable differences in pooled prevalence of ciprofloxacin and nalidixic acid between continents. The highest AMR pooled prevalence was found in Central and South America (79–85%) while Oceania and North America showed remarkably lower values than other continents (11–26%).There has been a clear rise in resistance to ciprofloxacin and nalidixic acid in Europe over the last two decades Harmonizing methodologies and reporting of results in scientific communities is strongly recommended. Over half of the Campylobacter spp. isolated from broiler meat at the retail level were resistant to fluoroquinolones. The pooled prevalence for ciprofloxacin was 60% (95% CI, 55–65), for nalidixic acid 65% (95% CI, 59–70), for enrofloxacin 56% (95% CI, 43–68), for ofloxacin 54% (95% CI, 32–75) and for levofloxacin 63% (95% CI, 21–96). There are noticeable differences in pooled prevalence of ciprofloxacin and nalidixic acid between continents. The highest AMR pooled prevalence was found in Central and South America (79–85%) while Oceania and North America showed remarkably lower values than other continents (11–26%). There has been a clear rise in resistance to ciprofloxacin and nalidixic acid in Europe over the last two decades