“One Health” perspective on the prevalence of Listeria monocytogenes and its antibiotic resistance profiles in South Africa: a comprehensive systematic review and meta-analysis

Abstract The emergence of Listeria monocytogenes pathogen threatens the era of antimicrobial drugs commonly used in treating listeriosis. This study reviewed the prevalence and antibiotic resistance profiles of L. monocytogenes in South Africa. The random-effect model meta-analysis was used to determine the pooled prevalence estimates (PPE) of L. monocytogenes isolates and their antibiotic resistance (AR) profiles from humans, food and the environmental samples. Original peer reviewed articles published from January 1 1990 to March 23 2024, were searched from PubMed, ScienceDirect, Google Scholar, Scopus, and African Journal Online databases. Comprehensive meta-analysis version 4.0 (CMA) software was used to calculate the PPE. A total of 2,931 samples (n = 1150 from humans, n = 1631 from food, and n = 150 from the environment) derived from 32 articles were incorporated into the meta-analysis. The overall PPE of L. monocytogenes was 73.3%, 33.5% and 44.5%, from human, food, and the environment samples, respectively. The L. monocytogenes serotype 4b-4d-4e had the highest PPE (19.5%). The AR profiles were screened from 1806 L. monocytogenes isolates with the overall multi-drug resistance PPE was 26.3%. The sulII resistance gene, which encodes a drug-resistant dihydropteroate synthase enzyme conferring resistance to sulfonamides, exhibited the highest prevalence of PPE at 47.3%. Among the isolates of L. monocytogenes from South Africa, the inlJ and inlB genes had high PPE values of 83.5% and 80.5%, respectively. These observations clearly demonstrate that L. monocytogenes is pathogen of “One Health” importance, which should not be under estimated. Therefore, a deliberate, concerted effort to formulate joint control and management of this bacteria is required from the human, animal, and environmental health sectors in South Africa.