Surgical Site Infections in Veterinary Practice: A Systematic Review of Pathogen Transmission, Antimicrobial Resistance, and One Health Implications

Introduction: Surgical site infection (SSI) is a common and preventable complication in veterinary medicine, which, in addition to increasing morbidity and mortality, has significant economic and public health consequences. However, patterns of pathogen transmission and antimicrobial resistance (AMR), and their links to the One Health approach, have been studied less systematically in this area. The present systematic review aimed to summarize the available evidence on the causative agents of SSI in veterinary medicine, the routes of pathogen transmission, the status of antimicrobial resistance, and its implications for human, animal, and environmental health.

Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases for articles published between January 2020 and December 2025. The keywords used were the combination of surgical site infection, veterinary, antimicrobial resistance, One Health, methicillin-resistant Staphylococcus, and cross-species transmission. Original observational, quasi-experimental, and cross-sectional studies that confirmed SSI in companion animals, horses, or large livestock and provided data on the microorganisms involved, antibiotic susceptibility patterns, or evidence of cross-species transmission were included.

Results: Of the 1,247 articles found, 28 studies met the inclusion criteria. The most common pathogens isolated were Staphylococcus aureus, Escherichia coli, Enterococcus spp., and Proteus species. More than 35% of staphylococcal isolates were methicillin-resistant (MRSP). Acquired resistance to fluoroquinolones and third-generation cephalosporins was observed in 12 studies. Strong evidence of transmission of the same resistant clones between surgical animals and veterinary personnel was reported in 16 studies. Only 18 studies reported shedding of resistant pathogens via clinic wastewater or animal bedding.

Conclusion: SSI in veterinary medicine is often caused by multidrug-resistant pathogens that have a high potential for interspecies and environmental transmission. Integration of antibiotic stewardship programs in veterinary medicine, along with integrated unit health surveillance, is essential to address this growing threat.