Prevalence of antimicrobial resistance genes in 'Salmonella' Typhi: A systematic review and meta-analysis

Salmonella enterica serovar Typhi (S. Typhi) that has developed resistance to many an- timicrobials poses a serious challenge to public health. Hence, this study aimed to systematically determine the prevalence of antimicrobial resistance (AMR) in 'S. Typhi' isolated from the environment and humans as well as to ascertain the spread of the selected AMR genes in 'S. Typhi'. This systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, and the study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). A total of 2353 studies were retrieved from three databases, of which 42 studies fulfilled the selection criteria. The pooled prevalence of AMR 'S. Typhi' (using a random-effect model) was estimated at 84.8% (95% CI; 77.3-90.2), with high heterogeneity (I2: 95.35%, p-value < 0.001). The high estimated prevalence indicates that control methods should be improved immediately to prevent the spread of AMR among 'S. Typhi' internationally.