Aeromonas characteristics in Iran, Southwest Asia; a systematic review and meta-analysis on epidemiology, reservoirs and antibiotic resistance profile from aquatic environments to human society during 2000-2023

BACKGROUND: As recent evidence shows the prevalence and transmission of Aeromonas species in Southwest Asia, and there is no updated information on the characteristics of Aeromonas in Iran, we conducted this review. We systematically searched biomedical databases (PubMed, Web of Sciences, Scopus, SID, ISC, and Google Scholar) to identify relevant studies investigating the prevalence, antibiotic resistance, and main reservoirs of Aeromonas in aquatic animals and human clinical specimens during 2000-2023 in Iran. Cochrane's Q test and I^2 statistical test was used to assess heterogeneity, and publication bias was assessed using funnel plots and random effects tests. RESULTS: In Iran, among 8347 human clinical samples and 1802 animal and food samples, only 87 (1.04%) and 388 (21.53%) samples were positive for Aeromonas spp. respectively, and the most isolated species was A. hydrophila. The main reservoir for Aeromonas spp. were twenty-four genera of aquatic animals besides minced meat, pigeon stool and chicken meat. In Iran, Aeromonas spp. isolates showed maximum resistance to ampicillin, tetracycline, nalidixic acid and vancomycin. The heterogeneity test for prevalence of Aeromonas species on human samples and animals or food products was significant (88.1256, (5), P-value < 0.0001) and the heterogeneity rate was 97.34% with a confidence interval of 0.2-4.3 and (194.02, (10), P-value < 0.0001) and the heterogeneity rate was 94.85% with a confidence interval of 15,124 - 33,335 respectively. CONCLUSIONS: According to these results, it is essential for exclusive attention to the prevalence and antibiotic resistance of Aeromonas in different provinces of Iran. Furthermore, special planning should be done for prevention, outbreak control and proper treatment of infections in the aquaculture industry and human societies.

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A systematic review of Iranian studies (2000-2023) found Aeromonas in 1.04% of human clinical samples and 21.53% of animal/food samples, dominated by A. hydrophila, with high resistance to ampicillin, tetracycline, nalidixic acid, and vancomycin.

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