ReviewOne health (Amsterdam, Netherlands)2026
A One Health view of antimicrobial resistance in North Africa: Meta-analysis of ESBL-producing Enterobacteriaceae across sectors.
Review in One health (Amsterdam, Netherlands), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Emergence of gene associations in high-risk K. pneumoniae clones: blaArchives of microbiology · 2026Article
- Whole-genome sequencing and molecular analysis of carbapenem-resistantFrontiers in microbiology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Antimicrobial resistance is a growing global health threat, and extended-spectrum β-lactamase-producing Enterobacterales exemplify a critical challenge. Because these organisms circulate across human, animal, food, and environmental reservoirs, a One Health perspective is essential for understanding their epidemiology. However, comprehensive regional syntheses remain limited in North Africa. Methods: This systematic review and meta-analysis synthesized evidence from 182 studies published between 2000 and 2024 on ESBL-producing Enterobacterales across North Africa within a One Health framework. We analyzed epidemiological data from human, animal, food, and environmental sources, as well as reported resistance genes, mobile genetic elements, transferability patterns, and clonal diversity associated with ESBL dissemination in the region. Results: In the human sector, the pooled prevalence estimate (PPE) of ESBL-producing Enterobacterales in clinical infections was 32.9%, with a higher burden in healthcare-acquired infections (37.1%) than in community-acquired infections (20.1%). ESBL carriage was also frequent at admission (34.1%) and increased after hospitalization (51.1%). Among non-human sectors, the PPE was 10.9% in animals, 3.73% in food, and 40.7% in environmental sources. Conclusion: ESBL-producing Enterobacterales are widely disseminated across interconnected human, animal, food, and environmental compartments in North Africa. Their regional epidemiology is shaped by a high human burden, substantial environmental reservoirs, frequent multidrug resistant backgrounds, mobile genetic elements, horizontal gene transfer, and the circulation of multiple clonal lineages. These findings highlight the need for strengthened and integrated One Health surveillance in North Africa.
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Registered trials
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