{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:45:32Z","timestamp":1791963932983,"version":"4.3.4"},"reference-count":412,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Vancomycin\u2010resistant enterococci (VRE) are an increasing public health concern. However, the contribution of environmental reservoirs to the global epidemiology of vancomycin resistance remains unclear. This meta\u2010analysis estimated the prevalence of Vancomycin\u2010resistant\n                    <jats:italic>Enterococcus faecalis<\/jats:italic>\n                    (VREfs) and vancomycin\u2010resistant\n                    <jats:italic>Enterococcus faecium<\/jats:italic>\n                    (VREfm) from clinical and environmental specimens worldwide. We conducted a systematic literature search in PubMed, Web of Science, Embase, and Scopus up to 26 April 2025. Statistical analysis was performed using the meta and metaphor packages in R, and heterogeneity was evaluated using I\n                    <jats:sup>2<\/jats:sup>\n                    . We assessed potential publication bias using Egger's test. A total of 349 eligible studies were included. The pooled prevalence of VREfm was 25%, and VREfs was 5%. The prevalence of both VREfs and VREfm increased significantly during the last two decades. The highest prevalence of VREfm and VREfs was found in rectal swabs (76%), hospital environmental samples (74%), environmental water (26%), and animal stool (40%). By integrating clinical and environmental data, the present study highlights the possible role of non\u2010clinical reservoirs in the persistence and dissemination of VRE. Our results support the One Health approach for VRE surveillance and emphasize the need for environmental surveillance in infection prevention and antimicrobial resistance control strategies.\n                  <\/jats:p>","DOI":"10.1002\/mbo3.70434","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:53:11Z","timestamp":1791960791000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Global Prevalence of Vancomycin\u2010Resistant\n                    <i>Enterococcus faecium<\/i>\n                    and\n                    <i>Enterococcus faecalis<\/i>\n                    Isolated From Clinical and Environmental Sources: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1103-3572","authenticated-orcid":false,"given":"Negar","family":"Narimisa","sequence":"first","affiliation":[{"name":"Department of Microbiology, School of Medicine Iran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4584-2327","authenticated-orcid":false,"given":"Tahereh","family":"Navidifar","sequence":"additional","affiliation":[{"name":"Department of Basic Sciences Shoushtar Faculty of Medical Sciences Shoushtar Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuqa T.","family":"Hameed","sequence":"additional","affiliation":[{"name":"College of Dentistry University of Al Maarif Al Anbar Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roghayeh","family":"Mohammadzadeh","sequence":"additional","affiliation":[{"name":"Food Safety Research Center (salt) Semnan University of Medical Sciences Semnan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faranak","family":"Abdoli","sequence":"additional","affiliation":[{"name":"Research Center for Clinical Virology Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa","family":"Ghamari","sequence":"additional","affiliation":[{"name":"Department of Pathobiology, School of Public Health Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delaram","family":"Nourollahi","sequence":"additional","affiliation":[{"name":"Research Center for Clinical Virology Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Ansari","sequence":"additional","affiliation":[{"name":"Research Center for Clinical Virology Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arefeh","family":"Ansari","sequence":"additional","affiliation":[{"name":"Science at Capilano University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4500-5764","authenticated-orcid":false,"given":"Narjess","family":"Bostanghadiri","sequence":"additional","affiliation":[{"name":"Research Center for Clinical Virology Tehran University of Medical Sciences Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1186\/s13104-015-1200-2","article-title":"Antimicrobial Resistance Profile of Enterococcus Species Isolated From Intestinal Tracts of Hospitalized Patients in Jimma, Ethiopia","volume":"8","author":"Abamecha A.","year":"2015","journal-title":"BMC Research Notes"},{"issue":"3","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1089\/mdr.2015.0121","article-title":"Low Level of Resistance in Enterococci Isolated in Four Hospitals, Marseille, France","volume":"22","author":"Abat C.","year":"2016","journal-title":"Microbial Drug Resistance"},{"issue":"3","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.patbio.2008.02.008","article-title":"Enterococcus Faecium Isolated From Bone Marrow Transplant Patients in Tunisia: High Prevalence of Antimicrobial Resistance and Low Pathogenic Power","volume":"57","author":"Abbassi M. 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