Fresh Vegetables as a Source of Multidrug Resistant Pathogens

Background: Global increase of fresh vegetables consumption as a healthy food, often eaten raw, raises concerns about foodborne illnesses and the spread of antimicrobial-resistant pathogens due to contamination through various sources.

Objective: To determine the microbial quality of common vegetables in the Gaza Strip and the antimicrobial resistance of bacteria recovered from vegetables samples.

Methods: One-hundred and fifty vegetable samples consisting of ten types (10 samples of Cabbage, 20 Red cabbage, 20 Cucumber, 20 Tomato, 10 Parsley, 20 Eruca, 10 Green mint, 10 Lettuce, 20 Radish, and 10 Green onion) were collected from local farms and markets. Standard microbiological techniques were used to quantify (total viable count, coliform, Staphylococcus aureus, Pseudomonas and Enterococcus) and identify bacteria. Antimicrobial susceptibility testing (disk diffusion and microbroth dilution) was performed in accordance to clinical and laboratory standards institute (CLSI document).

Results: Most samples (98%) were positive for coliforms, followed by Pseudomonas (94%), Staphylococcus aureus (89.3%), and Enterococcus (81.3%). High levels of antibiotic resistance were observed across various bacterial species. Enterobacteriaceae showed the highest resistance to ceftriaxone (76.2%) and the lowest resistance to amikacin (8.2%). Staphylococcus aureus had the highest resistance to penicillin (92.6%) and the lowest resistance to clarithromycin/levofloxacin (22.8%). Enterococcus spp. displayed the highest resistance to penicillin (94.4%) and the lowest resistance to norfloxacin (21.6%). Finally, Pseudomonas exhibited the highest resistance to ertem (70.9%) and the lowest resistance to amikacin (25.4%).

Conclusion: Microbial contamination and antimicrobial resistance in vegetables pose a significant public health threat in the Gaza Strip. Improved agricultural practices, enhanced food safety, responsible antimicrobials use, and continuous monitoring are crucial to mitigate these risks.