Prevalence of Vancomycin-Resistant Enterococcus (VRE) in Poultry in Malaysia: The First Meta-Analysis and Systematic

Yusuf Wada1,2, Ahmad A Irekeola1,3, Rafidah H Shueb1

  • 1Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.

Insights

The pooled prevalence of vancomycin-resistant Enterococci (VRE) in Malaysian poultry was 24.0%. This meta-analysis highlights the urgent need for increased VRE surveillance in poultry populations across Malaysia.

Area of Science:

  • Veterinary Microbiology
  • Antimicrobial Resistance
  • Public Health

Background:

  • Vancomycin-resistant Enterococci (VRE) pose a significant threat to public health due to their resistance to a critical antibiotic.
  • Poultry serves as a potential reservoir and transmission route for VRE, necessitating an understanding of its prevalence in food animals.
  • Limited data exists on the overall prevalence of VRE in poultry within Malaysia.

Purpose of the Study:

  • To conduct a meta-analysis to estimate the pooled prevalence of VRE in poultry in Malaysia.
  • To identify potential sources of heterogeneity and publication bias in existing studies.
  • To provide evidence-based recommendations for future surveillance and control strategies.

Main Methods:

  • A systematic search of databases including PubMed, Scopus, and Google Scholar was performed.
  • Data extraction and quality assessment were conducted by two independent reviewers, with a third reviewer resolving discrepancies.
  • Meta-analysis was performed using OpenMeta-Analyst and Comprehensive Meta-Analysis (CMA) software, employing a random-effects model to assess pooled prevalence and heterogeneity.

Main Results:

  • Seventeen studies published between 2000 and 2018, analyzing 8684 isolates, were included.
  • The pooled prevalence of VRE in Malaysian poultry was estimated at 24.0% (95% CI: 16.7-33.1%), with high heterogeneity (I² = 98.14%).
  • Pooled prevalence in chickens was 29.2% and in ducks was 11.2%. *Enterococcus faecalis* was the most frequently reported species, and antibiotic disc diffusion was the common detection method.

Conclusions:

  • A substantial prevalence of VRE exists in Malaysian poultry, indicating a potential public health concern.
  • High inter-study variability suggests differences in methodologies, geographical distribution, or bacterial strains across studies.
  • Enhanced surveillance programs for VRE in poultry are crucial for effective monitoring and control in Malaysia.