Staphylococcus aureus, a Gram-positive microorganism, naturally colonizes the skin and mucosal surfaces of approximately one-third of the healthy human population and is similarly found in various domestic and wild animals, including birds (Kadariya et al., 2014). Beyond its commensal existence, S. aureus is a known contaminant of various food items and is capable of causing staphylococcal food poisoning (SFP) through consuming food containing pre-synthesized enterotoxins (Léguillier et al., 2024). Staphylococcal enterotoxins (SEs) are typically grouped into two major categories: classical SEs and more recently identified non-classical forms (Shalaby et al., 2024). Among these, sea to see—classified as classical SEs—are the most commonly reported. Strains of S. aureus harboring genes that encode these enterotoxins and can express them under conducive conditions in food are thus considered potential foodborne pathogens (Léguillier et al., 2024; Shalaby et al., 2024).

Methicillin-resistant S. aureus first emerged in the 1960s and has since spread to be of global concern (Kadariya et al., 2014). Historically, MRSA was associated with nosocomial infections (HA-MRSA) in patients with co-morbidities. In the 1990s, community-associated MRSA (CA-MRSA) emerged and were associated with community acquired infections in previously healthy individuals (Enright et al., 2002; Roy et al., 2024). These CA-MRSA lineages have now evolved to be the main drivers of nosocomial infections in many regions globally. In the United Arab Emirates (UAE), national antimicrobial resistance surveillance data spanning over a decade reveals an alarming upward trend of MRSA infections from 21.9% in 2010 to 33.5% in 2021 (Thomsen et al., 2023). Notably, CA-MRSA lineages dominate clinical settings across the UAE, and their considerable genetic diversity suggests a dynamic epidemiological landscape likely driven by the country’s status as a global hub with a highly diverse population (Moradigaravand et al., 2023).

The emergence of MRSA in the food chain has garnered global attention, particularly its detection in raw and processed meat products (González-Machado et al., 2024; Khalifa et al., 2025). A systematic review revealed that MRSA was detected in 84.3% of the studies (n= 165) conducted on retail foods, even though the actual sample-level prevalence often remained below 20% (González-Machado et al., 2024). Beyond meat, fresh produce—including leafy greens, fruits, and vegetables—may also become contaminated with Staphylococcus spp. at various points in the food supply chain (Khalifa et al., 2025). Recently, our group reported the first isolation in the UAE of a mecA-positive MRSA strain belonging to sequence type ST-672 and spa type t384 from imported fresh dill (Habib et al., 2024). The principal public health concerns surrounding MRSA in food include its potential for community transmission and the risk of staphylococcal foodborne illness. In extreme cases, the ingestion of MRSA-contaminated food by a colonized or susceptible individual undergoing antibiotic treatment could allow for enterotoxin production in the gut, leading to disease (Sergelidis and Angelidis, 2017).

Despite the growing relevance of MRSA in food safety (Sergelidis and Angelidis, 2017), there remains a significant data gap in the UAE concerning its prevalence and antimicrobial resistance in meat products. This study addressed that gap by assessing MRSA prevalence in raw meats (beef, sheep meat, camel meat, and chicken) and fresh produce (ready-to-eat fruit and vegetable cuts) available in UAE retail outlets. Specifically, this work investigates the carriage of classical enterotoxin genes, evaluates antibiotic resistance patterns, and identifies the extent of multidrug resistance among MRSA isolates. This study represents the first comprehensive examination of MRSA prevalence, resistance profiles, and enterotoxin gene occurrence in retail foods of animal origin in the UAE. The findings from this study contribute valuable data to the global understanding of foodborne MRSA transmission risks, particularly from underreported regions.

Our study provides the first comprehensive data evaluating the prevalence and characteristics of MRSA in retail foods of animal and plant origin in the UAE. This work addresses a significant data gap in the region and highlights the potential of MRSA as a foodborne pathogen. By investigating multiple food types, our findings contribute valuable baseline information to inform national food safety surveillance and One Health initiatives in the UAE.

Our findings show a relatively high overall MRSA prevalence of 47.7% in retail meat and produce samples in the UAE. Our concluded prevalence in chicken meat (75.0%) notably exceeds values reported from several regions. For instance, MRSA was detected in only 1.7% of fresh chicken meat samples in a study from China (Wang et al., 2013), whereas a prevalence of 56.3% was reported in whole chicken carcasses examined in Egypt (Elshebrawy et al., 2025). A study by Bernier-Lachance et al. (2020) in Canada found a prevalence of just 1.2%. Given that the enrichment method applied in this study was also used in comparable investigations cited herein, the higher MRSA prevalence observed in retail chicken meat samples is unlikely to be due to methodological artifacts. Instead, such variation may reflect differences in regional production systems, antimicrobial usage patterns, and biosecurity measures influencing MRSA contamination along the poultry supply chain.

Regarding beef and sheep meat, our observed MRSA prevalence of 45.7% and 44.0% is higher than some reported rates elsewhere. Studies from Canada and the United States have generally reported lower prevalence — for example, Bhargava et al. (2011) observed just 1.3% in beef, and Weese et al. (2010) found 5.6%. A report from Egypt found a rate of 4% among MRSA from beef (Hasanpour Dehkordi et al., 2017). In terms of sheep meat, our results (24% prevalence) are higher than reported in Iran (Hasanpour Dehkordi et al., 2017), and higher than the 0–5% levels reported in some European studies (González-Machado et al., 2024).

Data on camel meat MRSA prevalence is scarce globally, hence, our study strengthens the global data pool by providing novel insights into the occurrence of MRSA in camel meat, a culturally and economically important commodity in the Middle East. Compared to our finding, a Jordanian study by Quddoumi et al. (2006) found MRSA in 12.5% of camel meat samples, significantly lower than the 55% prevalence we observed. Consistent with our findings, Raji et al. (2016) and Alkuraythi et al. (2023) reported that camel meat exhibited the highest MRSA contamination rate among tested red meat types in Saudi Arabia. This suggests potential emerging risks in niche meat products in the UAE, possibly due to under-regulated handling or niche processing channels.

The logistic regression analysis strongly implicates product form as a driver of MRSA contamination in beef. Minced beef had a significantly higher prevalence (78.5%) than boneless or bone−in pieces ( Table 2 ). Mincing disrupts the natural surface barrier, exposes fat and connective tissues rich in water activity, and vastly enlarges the surface area on which MRSA can adhere and multiply. It also funnels meat from multiple carcasses through common grinders and conveyors, multiplying opportunities for cross−contamination, especially if sanitation or temperature control is sub−optimal (Nastasijevic et al., 2023). Although the camel−meat regression model did not reach statistical significance (p = 0.087) ( Table 2 ), the point estimate mirrors the beef pattern, suggesting that trimming boneless cuts could lower the bacterial load by removing surface tissue, whereas bone−in portions, which are often exposed to saw−blade aerosols, remain highly contaminated (72.7%). Given the cultural importance of camel meat in the region (Mohamed et al., 2024), this apparent reduction should not be dismissed; additional, adequately powered studies are warranted to refine the risk estimate. In contrast, chicken showed uniformly high MRSA prevalence in both whole carcasses and parts (~75%), with no difference between forms. This likely reflects the dominance of automated cutting lines in modern poultry abattoirs, where equipment surfaces, scalding tanks, and chilling baths create homogenous contamination pressure. Consequently, interventions for poultry should focus on upstream processing hygiene and equipment sanitation rather than product form only, whereas beef—and potentially camel—require distinct control points for minced versus intact cuts to mitigate consumer exposure.

Our study detected MRSA at comparatively lower rates in retail vegetable (30.0%) and fruit cut (16.7%) samples in the UAE. These findings are consistent with international reports confirming the presence of MRSA in fresh produce, albeit at varying prevalence rates. For instance, a Malaysian study found MRSA in 21.4% of leafy vegetables (González-Machado et al., 2024). A study from China also supports the potential for MRSA contamination in fresh produce, with a reported prevalence of 1.0% in vegetables and 20.5% in fresh-cut fruits and vegetables (Wang et al., 2017). In North America, MRSA was identified in 28.2% of vegetable samples in a U.S. study (Yigrem et al., 2022) and 1.4% of plant-based imports in Canada (Jung and Rubin, 2020). Although the UAE results drawn from the present study fall within this global range, detecting MRSA in raw produce remains a public health concern, especially since some of these products are consumed without cooking, bypassing a critical control point for pathogen inactivation. The findings highlight the need for enhanced hygiene practices during post-harvest handling, slicing, and retail display, as well as strengthening surveillance programs to monitor emerging trends and protect consumer health.

MRSA resistance patterns in UAE retail foods reflect concerning variation. The notably high resistance to gentamicin (50%) and ciprofloxacin (up to 88%) in camel and beef isolates suggests selective pressure from the use of aminoglycosides in camel pastoral systems and fluoroquinolones in intensive cattle farming (Nastasijevic et al., 2023; Mohamed et al., 2024). This aligns with findings from various settings, such as ciprofloxacin resistance rates of 80–100% in MRSA isolated from retail beef in Louisiana (USA) and camel meat in Riyadh (KSA) (González-Machado et al., 2024; Khalifa et al., 2025). In contrast, chicken isolates showed the highest levels of resistance to macrolides and lincosamides—particularly erythromycin (85%) and clindamycin (55%)—a pattern consistent with data from a longitudinal study in Algeria (Belhout et al., 2022), and likely driven by the historical use of these antimicrobials in poultry production. Importantly, inducible clindamycin resistance (ICR) was detected only in meat-derived isolates, particularly from beef (53.6%) and sheep (41.2%), supporting previous evidence that ICR is primarily associated with livestock sources and rarely found in plant-based foods (Endale et al., 2023). These findings highlight the importance of implementing targeted, commodity-specific antimicrobial resistance surveillance in the UAE, aligned with a One Health approach that recognizes the interconnectedness of human, animal, and environmental health.

Our findings underscore the high prevalence of MDR among foodborne MRSA isolates, with nearly 80% of isolates characterized in the present study were resistant to three or more antimicrobial classes. The presence of such broadly drug-resistant MRSA in the food chain is a significant public health concern, as it compromises treatment options for potential infections. Comparable high MDR rates in food-associated MRSA have been reported in other regions, including neighboring Saudi Arabia and beyond. For instance, a study in Riyadh found that most MRSA isolates from retail processed foods were MDR, with a notable proportion even carrying vancomycin-resistance genes (Alghizzi et al., 2021). Likewise, in Nigeria over 80% of poultry meat MRSA isolates were MDR, and a few were resistant to all tested antibiotics (Igbinosa et al., 2023). The emergence of MDR-MRSA in diverse food products has also been documented (Mohammed et al., 2025), underscoring the global nature of this threat. Collectively, these findings highlight a need for strict antibiotic stewardship in agriculture and improved food hygiene measures to curb the spread of MDR pathogens from farm to fork and protect public health.

In addition to being found in foods, enterotoxigenic MRSA strains have also been isolated from individual patients and involved in a few reported foodborne outbreaks (Sergelidis and Angelidis, 2017). Around 95% of SFP cases are linked to the classical enterotoxins sea to see (Oliveira et al., 2022). Therefore, our study focused on screening S. aureus isolates for these five major SE genes. In the present study, the sea gene was the most commonly detected in 29.1% of all characterized MRSA isolates. This aligns with findings reported in China (29.7%) (Wang et al., 2017), Malaysia (30.8%) (Puah et al., 2016) and the USA (25.8%) (Ge et al., 2017). The high prevalence of the sea gene in MRSA isolates from retail food in the present study is notable, given that sea is the most commonly linked enterotoxin in SFP cases worldwide (Sergelidis and Angelidis, 2017; Shalaby et al., 2024). On the other hand, the detection of MRSA harboring the eta gene—that encodes for exfoliative toxin A (ETA) which is classically associated with staphylococcal skin infections—in retail fruit− and vegetable−cut samples is epidemiologically noteworthy; eta−positive strains are uncommon in the wider S. aureus population (≈5%) but are disproportionately of human origin (Linz et al., 2023), reflecting a possible nasal or cutaneous carriage in food handlers rather than primary contamination on the farm. To minimize the dissemination of MDR and toxigenic MRSA through the food value chain, preventive measures should focus on strengthening on-farm biosecurity and enforcing prudent antimicrobial use in food animal production. In addition, strict adherence to hygiene standards during slaughter, processing, and retail handling, combined with consumer education on safe food practices, is essential to reduce the risk of transmission to humans.

MRSA isolates co-harboring MDR and toxigenic determinants have indeed been reported in various regions. For example, in Cameroon, all MRSA isolates in one study were MDR and over half carried the PVL toxin gene (Mohamadou et al., 2022). Similarly, a Pakistani study found that around 69% of S. aureus isolates harbored the mecA resistance gene while also carrying various toxin genes (e.g., the enterotoxin gene sea in 53.2% of isolates and the toxic shock syndrome toxin gene tst in 24.2%), with 42 of 62 isolates co-occurring mecA and multiple virulence factors (Tasneem et al., 2022). Likewise, in Egypt, the majority of MRSA isolates were reported to be MDR and simultaneously positive for toxin genes such as sea and PVL (Abd El-Hamid et al., 2022). The co-occurrence of MDR and toxigenic genes is alarming because it produces strains that are not only difficult to treat but also highly virulent, thereby greatly increasing the public health risk by enabling the spread of staphylococcal infections that pose significant challenges to current therapeutic strategies.

Overall, this study provides valuable insights into MRSA’s AMR profiles and toxin gene distribution in retail foods of animal and plant origin in the UAE. As one of the first efforts within a One Health framework to align MRSA surveillance across food sources in Dubai, the study contributes important baseline data to inform national risk assessments and public health interventions. Nonetheless, several limitations should be acknowledged. First, we did not collect nasal swabs or hand wash samples from food handlers at the sampling sites. While such data would have helped establish a clearer link between food contamination and food handler’s carriage, this aspect was outside the scope of the study, which focused on retail food matrices. Future studies are recommended to incorporate human sampling to better trace contamination pathways. Second, the study was geographically limited to Dubai, so it was chosen as a case study due to its diversity and relevance within the UAE and as part of an integrated ongoing One Health investigation across food, clinical, animal, and environmental sectors. While Dubai offers a rich sampling environment, extending surveillance to other emirates is important for enhancing the representativeness and generalizability of findings. Sampling from other emirates or regions where camel meat is more accessible will also ensure broader coverage of this culturally significant food item. There is also a need to conduct WGS characterization of MRSA isolates to assess their relatedness to community-acquired strains and better understand their public health significance.

The findings reveal a high overall prevalence of MRSA, particularly in chicken, beef, and camel meat, and to a lesser extent in fruit and vegetable cuts. The detection of key virulence genes, such as sea and eta, alongside notable resistance to antimicrobials, raises concerns about the potential role of MRSA as a foodborne pathogen and the risk of transmission through the food chain. Future research should expand geographically, include food handlers in sampling protocols, and continue exploring culturally relevant food items to better inform national food safety strategies and antimicrobial resistance mitigation plans. Although this study is regionally focused on Dubai, its findings have broader significance. The high prevalence of multidrug-resistant and toxigenic MRSA in retail foods underscores foodborne transmission risks relevant to global supply chains. Key lessons, including the need for One Health surveillance, better food hygiene, and prudent antimicrobial use, apply to other regions and support coordinated international strategies to reduce the public health threat of MRSA.