Meta-analysis of the global prevalence of Enterococcus spp. in foods: Antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium

Aim: The objective of this study was to evaluate the prevalence and diversity of Enterococcus spp. and antibiotic-resistant Enterococcus faecalis and Enterococcus faecium isolates in different foods worldwide. Method and Result: This study used meta-analytical methods. Besides, Web of Science (n= 705), Medline (n= 6), and Scopus (n= 1.338) were searched for studies in the years 1995-2021 using related keywords. Results showed that the pooled prevalence for Enterococcus spp. and antibiotic-resistant of E. faecalis and E. faecium isolates were found 0.41 (95% C.I. 0.34-0.47), 0.25 (95% C.I. 0.13-0.38), respectively. According to the results of the subgroup analysis, the lowest and highest prevalence of Enterococcus spp. in food types were calculated for red meat (0.56), and fermented foods (0.29). Also, as a result of subgroup analyses by country the highest prevalence of Enterococcus spp. was calculated in studies conducted in Slovakia (0.74). In contrast, the lowest prevalence was calculated in studies conducted in Georgia (0.07). Conclusion: The meta-analyses improved our understanding of the prevalence of Enterococcus spp. and the antibiotic resistance of E. faecalis and E. faecium isolates in different foods and provided results that can be useful as input for quantitative microbiological risk evaluation modeling. Significance and Impact of Study: We demonstrated the antibiotic resistance of E. faecalis and E. faecium in foods and gaps that could be addressed in the future. Therefore, it is believed that the results compiled herein will contribute to the epidemiological surveillance of the presence and antibiotic resistance of E. faecalis and E. faecium in foods.