A large meta-analysis of the global prevalence rates of S. aureus and MRSA contamination of milk.

Past reports have indicated a high prevalence of milk contaminated with Staphylococcus aureus (S. aureus) and methicillin-resistant Staphylococcus aureus (MRSA), but the pooled prevalence rates of S. aureus and MRSA in pasteurized and boiled cow's milk, raw cow's milk, and raw Caprinae milk (raw sheep's milk and raw goat's milk) and across different periods, continents, economic conditions and purchase locations remain inconsistent. We searched relevant articles published in PubMed, EMBASE, and Web of Science before July 2016. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement was used to evaluate the quality of 93 included studies. We observed that the pooled prevalence rates of S. aureus contamination in pasteurized and boiled cow's milk, raw cow's milk, and raw Caprinae milk were 15.4% (95% CI, 6.1-27.5%), 33.5% (95% CI, 29.5-37.7%) and 25.8% (95% CI, 17.5-35.0%), respectively. The pooled prevalence rates of MRSA contamination were 4.9% (95% CI, 0.0-15.7%), 2.3% (95% CI, 1.3-3.6%), and 1.1% (95% CI, 0.5-1.8%), respectively. The prevalence of S. aureus contamination in raw cow's milk increased over time. However, the pooled prevalence of raw cow's milk contaminated with S. aureus was lowest in European studies. These findings give an indication of the consequence of better milk regulation in Europe. High S. aureus prevalence rates in raw milk collected from farms and processing companies pose a potential threat to consumers. The implementation of good hygiene practices, appropriate health knowledge, and food safety principles at the farm level, as well as the prudent use of antibiotics in veterinary medicine and heat treatment before drinking, are necessary to reduce the potential risk of S. aureus and MRSA contamination.