Department of Biotechnology and Food Science, Durban University of Technology, Steve Biko Campus, Steve Biko Rd, Musgrave, Berea, Durban, South Africa.
Sci Rep. 2024 Mar 22;14(1):6865. doi: 10.1038/s41598-024-57586-x.
Cronobacter sakazakii (Cz) infections linked with powdered milk/flour (PMF) are on the increase in recent times. The current study aimed at assessing worldwide and regional prevalence of Cz in PMF. Cz-PMF-directed data were conscientiously mined in four mega-databases via topic-field driven PRISMA protocol without any restriction. Bivariate analysis of datasets was conducted and then fitted to random-intercept logistic mixed-effects regressions with leave-one-study-out-cross-validation (LOSOCV). Small-study effects were assayed via Egger's regression tests. Contributing factors to Cz contamination/detection in PMF were determined using 1000-permutation-bootstrapped meta-regressions. A total of 3761 records were found out of which 68 studies were included. Sample-size showed considerable correlation with Cz positivity (r = 0.75, p = 2.5e-17), Milkprod2020 (r = 0.33, p = 1.820e-03), and SuDI (r = - 0.30, p = 4.11e-03). The global prevalence of Cz in PMF was 8.39% (95%CI 6.06-11.51, PI: 0.46-64.35) with LOSOCV value of 7.66% (6.39-9.15; PI: 3.10-17.70). Cz prevalence in PMF varies significantly (p < 0.05) with detection methods, DNA extraction method, across continents, WHO regions, and world bank regions. Nation, detection method, world bank region, WHO region, and sample size explained 53.88%, 19.62%, 19.03%, 15.63%, and 9.22% of the true differences in the Cz prevalence in PMF, respectively. In conclusion, the results indicated that national will power in the monitoring and surveillance of Cz in PMF matched with adequate sample size and appropriate detection methods will go a long way in preventing Cz contamination and infections.
阪崎克罗诺杆菌（Cz）与奶粉/面粉（PMF）相关的感染近来呈上升趋势。本研究旨在评估全球和地区 PMF 中 Cz 的流行情况。通过主题字段驱动的 PRISMA 协议，在四个大型数据库中认真挖掘与 Cz-PMF 相关的数据，没有任何限制。对数据集进行双变量分析，然后拟合具有随机截距逻辑混合效应回归和留一研究外交叉验证（LOSOCV）。通过 Egger 回归检验评估小研究效应。使用 1000 次置换 bootstrap 元回归确定 PMF 中 Cz 污染/检测的促成因素。共发现 3761 条记录，其中包括 68 项研究。样本量与 Cz 阳性率呈显著相关（r=0.75，p=2.5e-17）、Milkprod2020（r=0.33，p=1.820e-03）和 SuDI（r=-0.30，p=4.11e-03）。PMF 中 Cz 的全球流行率为 8.39%（95%CI 6.06-11.51，PI：0.46-64.35），LOSOCV 值为 7.66%（6.39-9.15；PI：3.10-17.70）。PMF 中 Cz 的流行率因检测方法、DNA 提取方法、各大洲、世卫组织区域和世界银行区域而异（p<0.05）。国家、检测方法、世界银行区域、世卫组织区域和样本量分别解释了 PMF 中 Cz 流行率的 53.88%、19.62%、19.03%、15.63%和 9.22%的真实差异。总之，结果表明，国家在 PMF 中监测和监测 Cz 的意愿加上足够的样本量和适当的检测方法，将有助于防止 Cz 污染和感染。
