Apramycin resistance in bacteria isolated from animals, a systematic review and meta-analysis (dataset)

Objective: To identify and assess published data pertaining to apramycin resistance in bacteria isolated from animals, to inform discussions related to the potential re-purposing of apramycin for use in humans Animals and procedures: A systematic review and meta-analysis of studies that reported apramycin susceptibility testing in bacteria from animals was performed. Results: Seventy-three references were included. Apramycin resistance was uncommon in E. coli and Salmonella from healthy pigs, poultry and cattle, with overall pooled prevalences being 7% (95% confidence interval 2-13%) for E. coli and 4% (1-17%) for Salmonella. In diseased animals, apramycin resistance was 27% (20-33%) in E. coli and 7% (4-11%) in Salmonella. Apramycin exposure was associated with a relative risk of apramycin resistance of 3.22 (95% CI 1.79-5.78). Conclusion and clinical relevance: The low overall resistance rates, despite decades of apramycin use, are encouraging. However, the apparent increase over time for E. coli and the limited available data regarding the impact of apramycin use on apramycin resistance highlight the gaps in evidence and challenges in interpreting the role of apramycin use on apramycin resistance in human or animal pathogens.