Microbiological quality assessment of fresh produce: Potential health risk to children and urgent need for improved food safety in school feeding schemes.

About 388 million school-going children worldwide benefit from school feeding schemes, which make use of fresh produce to prepare meals. Fresh produce including leafy greens and other vegetables were served at 37% and 31% of school feeding programs, respectively, in Africa. This study aimed at assessing the microbiological quality of fresh produce grown onsite or supplied to South African schools that are part of the national school feeding programs that benefit over 9 million school-going children. Coliforms, , Enterobacteriaceae, and were enumerated from fresh produce ( = 321) samples. The occurrence of , , spp., and extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae was determined. Presumptive pathogens were tested for antimicrobial resistance. was further tested for diarrheagenic virulence genes. Enterobacteriaceae on 62.5% of fresh produce samples (200/321) exceeded previous microbiological guidelines for ready-to-eat food, while 86% (276/321 samples) and 31.6% (101/321 samples) exceeded coliform and criteria, respectively. A total of 76 Enterobacteriaceae were isolated from fresh produce including ( = 43), spp. ( = 15), and spp. ( = 18). Extended-spectrum β-lactamase production was confirmed in 11 , 13 spp., and 17 spp. isolates. No diarrheagenic virulence genes were detected in isolates. However, multidrug resistance (MDR) was found in 60.5% (26/43) of the isolates, while all (100%;  = 41) of the confirmed ESBL and AmpC Enterobacteriaceae showed MDR. Our study indicates the reality of the potential health risk that contaminated fresh produce may pose to school-going children, especially with the growing food safety challenges and antimicrobial resistance crisis globally. This also shows that improved food safety approaches to prevent foodborne illness and the spread of foodborne pathogens through the food served by school feeding schemes are necessary.