{"title":"Phenotypic and genotypic landscape of antibiotic resistance through One Health approach in Sri Lanka: A systematic review.","authors":"Thilini Nisansala, Yasodhara Deepachandi Gunasekara, Nadisha Sewwandi Piyarathne","doi":"10.1111/tmi.14084","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Antibiotic resistance (ABR) constitutes a significant burden to economies in developing countries. In the 'One-Health' concept, ABR in human, animals, and environment is interconnected. The aim of this study was to critically appraise literature on ABR in all three domains in One Health, within the Sri Lankan geographical context.</p><p><strong>Methods: </strong>The protocol was registered with PROSPERO and followed PRISMA 2020 guidelines. A comprehensive electronic literature search was conducted in PubMed, Scopus, Web of Science databases and grey literature via Google Scholar. Out of 298 abstracts, 37 articles were selected following screening. A risk of bias assessment was conducted using Joanna Briggs Institute tools. Following blinded data extraction, descriptive data analysis and narrative synthesis were performed.</p><p><strong>Results: </strong>This review included studies published between 2016-2023. Of the included studies, 17 (45.9%) reported data on samples obtained from humans, 9 (24.3%) from animals, and 6 (16.2%) from environmental sources, two studies (5.4%) from humans and animals, one study on animal and environment; whereas two studies including all three domains. ABR of 32 different bacteria (Gram negative⸺17, Gram positive⸺14) was retrieved; E. coli was the most frequently studied bacteria followed by MRSA and ESBL. For E. coli, a median resistance over 50% was reported for sulfamethoxazole (88.8%), trimethoprim (79.1%), ampicillin (60%) and tetracycline (50.3%) with the highest resistance for erythromycin (98%). Of a total of 21 antibiotic-resistance genes in E. coli, the highest genotypic resistance was for tet-A (48.5%).</p><p><strong>Conclusions: </strong>A comprehensive description of ABR for a total of 32 bacteria, 62 antibiotics and 46 ABR genes is presented. This review discusses the contemporary ABR landscape in Sri Lanka through the One Health lens, highlighting key methodological and empirical research gaps.</p>","PeriodicalId":23962,"journal":{"name":"Tropical Medicine & International Health","volume":"30 3","pages":"143-158"},"PeriodicalIF":2.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873755/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tropical Medicine & International Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/tmi.14084","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/6 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Antibiotic resistance (ABR) constitutes a significant burden to economies in developing countries. In the 'One-Health' concept, ABR in human, animals, and environment is interconnected. The aim of this study was to critically appraise literature on ABR in all three domains in One Health, within the Sri Lankan geographical context.
Methods: The protocol was registered with PROSPERO and followed PRISMA 2020 guidelines. A comprehensive electronic literature search was conducted in PubMed, Scopus, Web of Science databases and grey literature via Google Scholar. Out of 298 abstracts, 37 articles were selected following screening. A risk of bias assessment was conducted using Joanna Briggs Institute tools. Following blinded data extraction, descriptive data analysis and narrative synthesis were performed.
Results: This review included studies published between 2016-2023. Of the included studies, 17 (45.9%) reported data on samples obtained from humans, 9 (24.3%) from animals, and 6 (16.2%) from environmental sources, two studies (5.4%) from humans and animals, one study on animal and environment; whereas two studies including all three domains. ABR of 32 different bacteria (Gram negative⸺17, Gram positive⸺14) was retrieved; E. coli was the most frequently studied bacteria followed by MRSA and ESBL. For E. coli, a median resistance over 50% was reported for sulfamethoxazole (88.8%), trimethoprim (79.1%), ampicillin (60%) and tetracycline (50.3%) with the highest resistance for erythromycin (98%). Of a total of 21 antibiotic-resistance genes in E. coli, the highest genotypic resistance was for tet-A (48.5%).
Conclusions: A comprehensive description of ABR for a total of 32 bacteria, 62 antibiotics and 46 ABR genes is presented. This review discusses the contemporary ABR landscape in Sri Lanka through the One Health lens, highlighting key methodological and empirical research gaps.
目的：抗生素耐药性（ABR）对发展中国家的经济构成重大负担。在“一个健康”的概念中，人类、动物和环境的ABR是相互关联的。本研究的目的是在斯里兰卡的地理背景下，对《同一个健康》中所有三个领域的ABR文献进行批判性评价。方法：该方案在PROSPERO注册，并遵循PRISMA 2020指南。通过谷歌Scholar对PubMed、Scopus、Web of Science数据库和灰色文献进行了全面的电子文献检索。从298篇摘要中筛选出37篇。使用乔安娜布里格斯研究所的工具进行偏见风险评估。在盲法数据提取后，进行描述性数据分析和叙述性综合。结果：本综述纳入了2016-2023年间发表的研究。在纳入的研究中，17项（45.9%）报告了来自人类的样本数据，9项（24.3%）来自动物，6项（16.2%）来自环境来源，2项（5.4%）研究来自人类和动物，1项研究来自动物和环境；然而两项研究涵盖了所有三个领域。收集了32种不同细菌的ABR（革兰氏阴性节节令17，革兰氏阳性节节令14）；大肠杆菌是最常见的研究细菌，其次是MRSA和ESBL。大肠杆菌对磺胺甲恶唑（88.8%）、甲氧苄啶（79.1%）、氨苄西林（60%）和四环素（50.3%）的中位耐药率均超过50%，其中对红霉素的耐药率最高（98%）。在大肠杆菌共21个耐药基因中，et- a基因型耐药率最高（48.5%）。结论：全面描述了32种细菌、62种抗生素和46种ABR基因的ABR。本综述通过“一个健康”视角讨论了斯里兰卡当代ABR状况，突出了关键的方法和实证研究差距。
期刊介绍：
Tropical Medicine & International Health is published on behalf of the London School of Hygiene and Tropical Medicine, Swiss Tropical and Public Health Institute, Foundation Tropical Medicine and International Health, Belgian Institute of Tropical Medicine and Bernhard-Nocht-Institute for Tropical Medicine. Tropical Medicine & International Health is the official journal of the Federation of European Societies for Tropical Medicine and International Health (FESTMIH).
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