Startseite Medizin Prevalence of Vancomycin-resistant Enterococcus in wild mammals: the first global systematic review and meta-analysis
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Prevalence of Vancomycin-resistant Enterococcus in wild mammals: the first global systematic review and meta-analysis

  • Mohammed Alissa ORCID logo EMAIL logo , Abdullah Alghamdi , Mohammed A. Alshehri , Suad A. Alghamdi , Ghadah S. Abusalim , Abdulkarim S. Binshaya und Ghada M. Alnafesah
Veröffentlicht/Copyright: 11. Dezember 2025
Reviews on Environmental Health
Aus der Zeitschrift Reviews on Environmental Health

Abstract

Introduction

Vancomycin-resistant Enterococcus (VRE) represents a global public health threat due to its ability to disseminate antimicrobial resistance (AMR) genes across ecological boundaries. While the prevalence of VRE has been extensively studied in clinical and agricultural settings, its occurrence and dynamics in wildlife remain underexplored. This review aimed to systematically examine and analyze the global prevalence of VRE in wild mammals.

Content

Following PRISMA guidelines, an extensive search of six databases yielded 25 studies that met predefined inclusion criteria. Data were extracted and synthesized using a random-effects model to estimate pooled prevalence rates, and subgroup analysis was also performed. Heterogeneity was quantified using the I² statistic, and publication bias was assessed through funnel plots and Egger’s test. The overall pooled prevalence of VRE in wild mammals was 8.4 % (95 % CI: 4.9–14.0), with significant heterogeneity (I² = 87.63 %). Southern Europe recorded the highest prevalence, particularly in Spain (18.6 %) and Portugal (7.0 %), while lower rates were observed in England (3.3 %) and Italy (4.5 %). Species-specific prevalence was highest in Eurasian otters and roe deer (62.1 % and 48.6 %, respectively). Methodological variability also influenced prevalence rates, with disc diffusion reporting the highest prevalence (17.3 %) compared to PCR-based methods (3.9 %).

Summary

The findings indicate a moderately significant prevalence of VRE in wild mammals, underscoring wildlife’s critical role as reservoirs and vectors of AMR.

Outlook

Anthropogenic factors such as agricultural activities and environmental pollution significantly shape the distribution and burden of VRE among wild animals.

Keywords: Vancomycin-resistant Enterococcus (VRE); antimicrobial resistance (AMR); wildlife epidemiology; one health approach and systematic review and meta-analysis
Corresponding author: Mohammed Alissa, Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia, E-mail:

Acknowledgments

This study is supported via funding from Prince Sattam bin Abdulaziz University project number (PSAU/2025/R/1447).

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: Conceptualization: M.A. and A.A. conceived and designed the study. Methodology: M.A, A.A, S.A.A, M.A.A, G.S.A. and A.S.B. selected and assessed the quality of studies. M.A. and A.S.B. extracted and analyzed data. Analysis and writing: A.A and M.A. interpreted the results and drafted the manuscript. Writing—review and editing: M.A, A.A, S.A.A, M.A.A, G.S.A and A.S.B reviewed and edited the manuscript. All authors have read and agreed to the published version of the manuscript.

  4. Use of Large Language Models, AI and Machine Learning Tools: Not applicable.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: Prince Sattam bin Abdulaziz University project number (PSAU/2025/R/1447).

  7. Data availability: Not applicable.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/reveh-2025-0140).

Received: 2025-10-03
Accepted: 2025-11-20
Published Online: 2025-12-11

© 2025 Walter de Gruyter GmbH, Berlin/Boston

https://doi.org/10.1515/reveh-2025-0140
Schlagwörter für diesen Artikel
Vancomycin-resistant Enterococcus (VRE); antimicrobial resistance (AMR); wildlife epidemiology; one health approach and systematic review and meta-analysis
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