The occurrence of Staphylococcus aureus, enterotoxigenic and methicillin-resistant strains in Iranian food resources: a systematic review and meta-analysis.

INTRODUCTION

Staphylococcus aureus, in particular its enterotoxigenic strains, is a well-known pathogen in food microbiology as one of the most common causes of food poisoning. This study aimed to investigate the prevalence of S. aureus enterotoxigenic strains in Iranian food resources by using a systematic review and meta-analysis.

METHODS

A systematic search was performed using electronic databases from papers that were published by Iranian authors to the end of July 2017. Then, 34 publications which met our inclusion criteria were selected for data extraction and analysis.

RESULTS

The average pooled prevalence of S. aureus in food resources was 15.5% (95% CI: 12.7%-18.9%) ranging from 1.1% to 52%. According to the examined publications the estimated average prevalence of enterotoxigenic strains was estimated at 53.7% (95% CI: 41.4%-65.6%) ranging from 13% to 83.3%. The average prevalence of methicillin-resistant S. aureus in contaminated resources was estimated at 15.5% (95% CI: 11.1%-21.4%) ranging from 0% to 32%. The results showed that SEA and SEG were the most prevalent classic and new staphylococcal enterotoxins' (SEs) types. The results of antibiotic resistance pattern showed the highest resistance rates to β-lactams, tetracycline and erythromycin.

CONCLUSIONS

The present analysis showed a significant presence of enterotoxigenic strains of S. aureus and a high rate of staphylococcal enterotoxins among food resources in Iran. However, also the prevalence of MRSA strains is remarkable and requires an improvement of the hygienic conditions to reduce the risk of MRSA dissemination in community and hospitals. Furthermore, the rational use of antibiotics in the environments related to food resources is recommended.