Prevalence of foodborne pathogens in ready-to-eat foods: systematic review, meta-analysis and meta-regression.

Ready-to-eat (RTE) foods are highly susceptible to microbial contamination, posing significant public health risks. This study aimed to conduct a systematic review, meta-analysis, and meta-regression to evaluate the prevalence of foodborne pathogens in RTE foods, assess trends over time, and examine the impact of the Global Food Security Index (GFSI). The search was conducted across Scopus, Web of Science, Embase, and PubMed until 2025. Studies reporting pathogen prevalence in RTE foods were included. Meta-analysis in defined subgroup and meta-regression assessed the effects of time and GFSI on prevalence trends. Sixty-five papers with 858 datasets comprising a total of 232,760 samples were included in the meta-analysis. Gram-negative pathogens (ES=18.32, 95 % CI: 15.29-21.53) were more prevalent than Gram-positive pathogens (ES=8.08, 95 % CI: 7.17-9.02). The African Region had the highest prevalence (ES=30.02, 95 % CI: 25.75-34.44), while the Americas had the lowest (ES=4.56, 95 % CI: 2.28-7.34). Contamination increased over time (C=0.018, p<0.001) but decreased with GFSI implementation (C=-0.005, p<0.001). RTE foods are highly vulnerable to contamination, particularly by Gram-negative pathogens. Regional disparities highlight the need for improved food safety infrastructure, especially in high-risk areas. Adopting global standards like GFSI and addressing emerging challenges such as antimicrobial resistance and climate change are essential for reducing foodborne illnesses.