Global distribution and molecular characteristics of antimicrobial-resistant coagulase-negative staphylococci (CoNS) in cats: a systematic review and meta-analysis

Coagulase-negative staphylococci (CoNS)have emerged as opportunistic pathogens and important reservoirs ofantimicrobial resistance (AMR) in companion animals. However, the globalepidemiology and resistance profiles of feline CoNS remain poorlycharacterized. This systematic review and meta-analysis aimed to synthesizeavailable data on the proportion, resistance patterns, and molecularcharacteristics of AMR-CoNS in cats worldwide. A comprehensive literaturesearch of PubMed, CABI, and Scopus was conducted in March 2025. Studiesreported the proportion and/or resistance data of CoNS isolated from cats wereincluded. Extracted data included study characteristics, number of resistantCoNS, species distribution, resistance profiles, and molecular characteristics.Pooled proportions were calculated using random-effects models, and risk of biaswas assessed using a modified quality assessment tool. Of 1,253 identifiedrecords, 65 studies met the inclusion criteria, yielding 3,539 CoNS isolates.The pooled proportion of resistant CoNS was 0.31 (95% CI: 0.17-0.49), with significantheterogeneity (I² = 98.4%, p < 0.001). Resistance levels werehighest in Asia, especially in China and Southeast Asia, moderate in Europe andNorth America, and lowest in other regions. Staphylococcus felis wasprevalent in Africa, Europe, and Oceania, while a broader range of CoNS specieswas identified in Asia and North America. Common resistance genes included blaZ,mecA, and different tet and erm genes. While overallmethodological quality was high, concerns were noted regarding case selectionand bacterial characterization. This review highlights a significant globalvariation in CoNS proportion and resistance patterns in cats, emphasizing theneed for standardized surveillance, improved diagnostics, and targeted antimicrobialstewardship.