A Systematic Review of β-Lactamase and Carbapenemase-Producing Escherichia coli at the Animal-Food Interface in the Middle East and North Africa.

Abstract

Antimicrobial resistance is a major global health challenge, and food-producing animals and foods of animal origin may contribute to the dissemination of resistant bacteria through the food chain. This review aimed to summarize recent evidence on extended-spectrum β-lactamase- and carbapenemase-producing Escherichia coli in food animals and animal-derived foods across Middle East and North Africa countries. A structured literature search was conducted to identify peer-reviewed studies published between 2016 and 2025. Data regarding country, sample type, prevalence, and resistance genes were extracted and analyzed descriptively. Twenty-eight studies from nine MENA countries revealed the presence of resistant E. coli in poultry, cattle, sheep, swine, camels, seafood, and other animal-derived products. Poultry showed a higher reported prevalence of extended-spectrum β-lactamase-producing E. coli, while carbapenem-resistant isolates were less frequently reported but were detected in several countries. The bla_CTX-M family was the predominant extended-spectrum β-lactamase determinant, whereas bla_NDM, bla_OXA-48-like, and bla_KPC were among the commonly identified carbapenemase genes. These findings demonstrate that food animals and animal-derived foods may represent important reservoirs of clinically relevant resistance genes in the Middle East and North Africa region. Strengthening One Health surveillance, antimicrobial stewardship, and regional collaboration is essential to limit the spread of resistant bacteria.