Emerging Foodborne Pathogens in Ready-to-Eat Foods: A Systematic Review of Global Prevalence, Detection Methods, and Public Health Implications

Abstract

This systematic review synthesizes global prevalence estimates of emerging foodborne pathogens in ready-to-eat (RTE) foods, evaluates detection methods, and analyzes public health implications. Following PRISMA 2020 guidelines, PubMed, Scopus, Web of Science, and FAO AGRIS were searched for studies published between January 2013 and December 2023. Of 2,187 records screened, 68 studies from 32 countries met inclusion criteria. Global pooled prevalence estimates were: Listeria monocytogenes 4.7% (95% CI: 3.5–5.9%), emerging Salmonella serovars 3.1% (95% CI: 2.2–4.0%), non-O157 Shiga toxin-producing Escherichia coli 2.3% (95% CI: 1.6–3.0%), Cronobacter spp. in powdered infant formula 6.8% (95% CI: 4.9–8.7%), and human norovirus in fresh produce 7.2% (95% CI: 5.1–9.3%). Molecular methods including qPCR and multiplex PCR demonstrated superior diagnostic accuracy (AUC: 0.92–0.98) and sensitivity (limit of detection: 1–10 CFU/g) compared to traditional culture-based methods. Meta-regression identified significantly higher prevalence in low- and middle-income countries compared to high-income nations (β = 2.1, p < 0.01). Emerging pathogens are consistently detected in RTE foods at levels of public health concern with marked geographic and product-type disparities. Strengthened harmonized surveillance, targeted control measures for high-risk products including soft cheeses and fresh produce, and investment in diagnostic capacity, particularly in low- and middle-income countries, are urgently needed.