Global Prevalence of Escherichia coli Infection in Cockroaches: A Systematic Review and Meta-Analysis

Authors

  • Maryam Hatamibardar Student Research Committee, Babol University of Medical Sciences, Babol, Iran
  • Mahdi Sepidarkish Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
  • Yasaman Dini Student Research Committee, Babol University of Medical Sciences, Babol,
  • Fatemeh Ramezani Student Research Committee, Babol University of Medical Sciences, Babol, Iran
  • Sina Nasrollahian Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
  • Mehrdad Halaji Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
  • Mohsen Karami Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran

Keywords:

Ectobiidae; Anti-Bacterial agents; Drug resistance; Periplaneta americana; Blattella germanica

Abstract

Background: Cockroaches are mechanical vectors of Escherichia coli, a key indicator of fecal contamination and anti­microbial resistance. Their presence in hospitals and households poses risks of healthcare‑associated and communi­ty‑acquired infections. However, no global quantitative prevalence estimate of E. coli in cockroaches is available. We systematically reviewed and meta-analyzed observational studies to estimate pooled global prevalence of E. coli in cockroaches and explore heterogeneity by site, species, and region.

Methods: We systematically searched PubMed, Scopus, Web of Science for observational studies report­ing E. coli prevalence in cockroaches (last search: January, 2026), without geographical or time restrictions. Pooled prevalence was estimated using a DerSimonian–Laird random‑effects model with Freeman‑Tukey double arcsine trans­formation. Subgroup analyses were predefined by sampling site, cockroach species and country. Heterogeneity was assessed using the I² statistic. The protocol was not registered in the International Prospective Register of Systematic Reviews (PROSPERO).

Results: The pooled global prevalence of E. coli colonization was 22.6%. In subgroup analyses, the highest and lowest prevalence of E. coli colonization were found in studies with external surface sampling (26.5%) and internal parts sam­pling (16.8%), respectively. The pooled prevalence of E. coli colonization in studies with American and German cock­roaches was 28.4% and 18.2 %, respectively. A significant difference was observed among cockroach-type subgroups.

Conclusions: This meta‑analysis reveals a substantial prevalence of E. coli contamination in cockroaches, particularly on external surfaces, in Periplaneta americana and in hospital/household settings. Further research is needed to develop targeted interventions for reducing associated public health risks.

Published

2026-11-03

Issue

Volume (20) issue (3)

Section

Articles