Foods (Dec 2024)

Insight into the Prevalence of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Vegetables: A Systematic Review and Meta-Analysis

  • Sebolelo Jane Nkhebenyane,
  • Ntelekwane George Khasapane,
  • Kgaugelo Edward Lekota,
  • Oriel Thekisoe,
  • Tsepo Ramatla

DOI
https://doi.org/10.3390/foods13233961
Journal volume & issue
Vol. 13, no. 23
p. 3961

Abstract

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The occurrence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in vegetables is an escalating global problem. This study aimed to document the global prevalence of ESBL-producing Enterobacteriaceae in vegetables using a comprehensive meta-analysis. A web-based search of electronic databases such as ScienceDirect, Google Scholar, and PubMed was conducted using studies published between 2014 and 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed for the systematic review and meta-analysis. The Comprehensive Meta-Analysis (CMA) Ver 4.0 software was used to analyse the data. The pooled prevalence estimate (PPE) with a 95% confidence interval (CI) was calculated using the random effects model. After reviewing 1802 articles, 63 studies were carefully analyzed and were part of the comprehensive meta-analysis. The overall PPE of ESBL-producing Enterobacteriaceae (ESBL-E) was 11.9% (95% CI: 0.091–0.155), with high heterogeneity (I2 = 96.8%, p blaSHV ESBL-encoding gene was the most prevalent, showing a PPE of 42.8% (95% CI: 0.269–0.603), while the PPE of blaampC-beta-lactamase-producing Enterobacteriaceae was 4.3% (95% CI: 0.025–0.71). Spain had a high ESBL-E PPE of 28.4% (0.284; 95% CI: 0.057–0.723, I2 = 98.2%), while China had the lowest PPE at 6.4% (0.064; 95% CI: 0.013–0.259, I2 = 95.6%). Continentally, the PPE of ESBL-E was significantly higher in reports from South America at 19.4% (95% CI: 0.043–0.560). This meta-analysis showed that ESBL-E in vegetables increased by 9.0%, 9.8%, and 15.9% in 2018–2019, 2020–2021, and 2022–2024, respectively. The findings emphasize the potential risks of consuming raw or inadequately cleaned produce and the importance of vegetables as ESBL-E reservoirs. Our work calls for immediate attention to food safety procedures and more thorough surveillance as antibiotic resistance rises to reduce antimicrobial resistance risks in food systems.

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