Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Dec;52(12):2516-2527.
doi: 10.18502/ijph.v52i12.14313.

Prevalence and Antibiotic Resistance of Clostridioides (Clostridium difficile) In Meat and Meat Products: A Systematic Review and Meta-Analysis

Zahra Esfandiari  1 , Parisa Shoaei  2 , Bahareh Vakili  3 , Ziba Farajzadegan  4 , Mohammad Javad Tarrahi  5 , Zahra Emami  6 , Yadolah Fakhri  7 , J Scott Weese  8 , Trias Mahmudiono  9
Affiliations
Review

Prevalence and Antibiotic Resistance of Clostridioides (Clostridium difficile) In Meat and Meat Products: A Systematic Review and Meta-Analysis

Zahra Esfandiari et al. Iran J Public Health. 2023 Dec.

Abstract

Background: Meat and meat products are introduced as one of the frequent sources of Clostridioides difficile. We aimed to determine the prevalence and antibiotic resistance of C. difficile isolates in meat and meat products using a systematic review and meta-analysis.

Methods: A literature search was performed in the primary international and bibliographic databases such as MEDLINE (PubMed), Cochrane Library, Embase, Scopus, and Web of Science to achieve all articles related to the prevalence and antibiotic resistance rates from 2007 to 2022.

Results: The 278 retrieved articles were reduced to 54 worldwide eligible studies after screening and matching inclusion/exclusion criteria. C. difficile was examined in different types of samples and its resistance to 10 antibiotics. The pooled prevalence of C. difficile was 3.4% in all samples. C. difficile pooled prevalence was detected in fish, poultry, and red meat groups with 6.9%, 5.2%, and 3.2%, respectively. Regarding antibiotic resistance, the highest pooled prevalence was for ciprofloxacin (86.6%), followed by clindamycin (42.6%) and erythromycin (34%). The lowest pooled prevalence was observed in metronidazole (7.6%), vancomycin (6.6%), and chloramphenicol (6%).

Conclusion: Low resistance was found to commonly used drugs for C. difficile infection (CDI) treatment. Since each antibiotic can be predisposing cause for CDI development, this finding possibly will be warning from a One Health viewpoint about the misuse of antibiotics in the chain of farm to fork including agriculture, animal husbandry and the food industry and also their injudicious use in medicine.

Keywords: Antibiotic resistance; Clostridioides difficile; Meat; Meta-analysis; Systematic review.

PubMed Disclaimer

Figures

Fig. 1:
Fig. 1:
PRISMA flow chart detailing review process
Fig. 2:
Fig. 2:
Forest plot of meta-analysis of C. difficile prevalence in meat and meat products
See this image and copyright information in PMC

References

    1. Lu CI, Li HX, Zhu XY, et al. (2022). Regulatory effect of intracellular polysaccharides from Antrodia cinnamomea on the intestinal microbiota of mice with antibiotic-associated diarrhea. Qual Assur Saf Crops Foods, 14: 124–134.
    1. Lawson PA, Citron DM, Tyrrell KL, et al. (2016). Reclassification of Clostridium difficile as Clostridioides difficile (Hall and O’Toole 1935) Prevot 1938. Anaerobe, 40: 95–9. - PubMed
    1. Weiss K. (2009). Toxin binding treatment for clostridium difficile: a review including reports of studies with tolevamer. Int J Antimicrob Agents, 33: 4–7. - PubMed
    1. Esfandiari Z, Jalali M, Ezzatpanah H, et al. (2014). Occurrence of Clostridium difficile in seasoned hamburgers and seven processing plants in Iran. BMC Microbiol, 14:283. - PMC - PubMed
    1. Nourbakhsh F, Tajbakhsh E. (2021). Neurotoxicity mechanism of Ochratoxin A. Qual Assur Saf Crops Foods, 13: 34–45.

LinkOut - more resources