One Health Antimicrobial Resistance in Qatar: A Comprehensive Systematic Review and Meta-Analysis of Animal, Food,...

Background: Antimicrobial resistance (AMR) is a global threat that extends beyond clinical settings, impacting animals, food, and the environment. To the best of our knowledge, this review presents the first systematic evaluation of AMR and antimicrobial resistance genes (ARGs) in non-human sources in Qatar, using a One Health framework. Methods: Following PRISMA 2020 guidelines, we searched five major databases: PubMed, Scopus, Web of Science, Embase, Google Scholar (only 3 pages) and QRDI, without date restrictions for studies on AMR and ARGs in animals, food, and environmental sources in Qatar. Only primary studies from Qatar reporting phenotypic or genotypic AMR/ARG data in animals, food, or the environment were included; all human-focused, non-Qatar, or non-primary research were excluded. Eligible studies were screened and analyzed using GraphPad Prism 10.4 and StatsDirect, applying random- or fixed-effects models based on heterogeneity and assessed for quality using the JBI checklist for prevalence. Results: Fifteen eligible studies published up to 2025 were included. Escherichia coli was the most frequently reported organism. High resistance rates were observed in the Access group antibiotics, such as ampicillin (0.50; 95% CI: 0.47-0.53) and tetracycline (0.50; 95% CI: 0.45-0.55), as well as in the Watch group antibiotics, including ciprofloxacin (0.40; 95% CI: 0.36-0.44) and fosfomycin (0.26; 95% CI: 0.20-0.32). Resistance to Reserve group antibiotics was comparatively lower, with pooled estimates of 0.14 (95% CI: 0.08-0.20) for colistin and 0.11 (95% CI: 0.05-0.25) for carbapenems, though lower, remains concerning. The overall pooled estimate for multidrug resistance (MDR) was 0.56 (95% CI: 0.36-0.72), and poultry was identified as the main reservoir, particularly to Critically Important Antimicrobials (CIAs). ARGs, including bla_CTX-M, bla_TEM, mcr-1, and qnr, were detected across all sectors, with wastewater showing a notable ARG burden. Data on other livestock species remain limited. Limitations include a few studies, variable quality, and inconsistent methods affecting comparability and precision. Conclusions: This review highlights significant AMR and ARG prevalence in non-human sources in Qatar and underscores the urgent need for a national One Health surveillance strategy incorporating WHO AWaRe and CIA frameworks to address this escalating public health threat.