Ready-to-eat (RTE) foods are foods prepared for consumption, and they may be raw or cooked, served hot or chilled, and often eaten without any additional treatment or processing (Lund, 2019; Valiati et al., 2023). Most RTE foods in Africa include hamburgers, salads, macaroni salad, cooked/roasted meats, smoked fish, sandwiches, cheese, mushroom pasta, deli-style cheese, burritos, fajitas, freshly made sushi, desserts, and ice-creams such as doughnuts etc. (Lund, 2019; Valiati et al., 2023). The consumption of diverse RTE foods in public spaces has become prevalent globally. RTE foods are widely consumed in low- and middle-income countries (LMICs) because of their convenience, affordability, and palatability (Makinde et al., 2020). Given the essential significance of food in human life, it is imperative to uphold food safety to protect individuals from foodborne illnesses and other associated health risks (Mengistu and Tolera, 2020). At the same time, it could be a reservoir of antibiotic resistance (Igere et al., 2022b, 2024; Onohuean and Igere, 2022). Mainstream research has extensively focused on environmental sources (such as water and soil) and clinical surveillance as major reservoirs of bacteria antibiotic resistance (Igere et al., 2022a; Onohuean and Nwodo, 2023b; Regassa et al., 2023; Satán et al., 2023). There is sparse data on the distribution and prevalence of antibiotic resistance from RTE foods.

Furthermore, food safety involves preventing chemical, biological, pathogens, and other health hazards from contaminating food. However, improper handling and serving of RTE street food can cause contamination with pathogens such as Salmonella, Vibrio spp., Campylobacter, E. coli, Listeria monocytogenes, Toxoplasma gondii, Clostridium botulinum, Moulds and other foodborne pathogens including Cyclospora, Hepatitis A, and Cronobacter sakazakii (Beshiru et al., 2019; Igere et al., 2022a; Onohuean and Igere, 2022, 2023). The use of contaminated water, inadequate hygiene, and environmental sanitation also impacts the contamination of RTE food, resulting in typhoid fever and diarrhoea infections (Igere et al., 2023; Onohuean and Nwodo, 2023a). Therefore, RTE foods prepared with contaminated ingredients, water, and in an unsanitary setting can contain these bacteria, which significantly impacts public health.

Food contaminated with antibiotic-resistant pathogenic microorganisms poses a significant risk to public health. In addition to infecting people, they serve as potential reservoirs of antimicrobial resistance, facilitating the transfer of antibiotic-resistant components to both related and unrelated bacterial species (Odu and Akano, 2012; Beshiru et al., 2020; Onohuean and Igere, 2022). This has contributed to the global increase in antibiotic resistance among foodborne bacteria and infections in recent years. Regrettably, in many low-income African nations, most food vendors lack significant monitoring or licences by appropriate agencies or organizations overseen or accredited by relevant bodies or organizations to validate these RTE food safety. Again, these RTE food vendors could have compromised their products due to the environment and methods employed, increasing the likelihood that some are infected with bacterial infections. Although critical to health and productivity, food hygiene has been significantly overlooked in African research.

Antimicrobials, including antibiotics, are medications used to treat or prevent bacterial infections in humans and animals. Globally, antimicrobial resistance (AMR) in RTE foods has impacted product safety and quality. Countries with rigorous food safety standards, such as the European Union and the United States, impose stricter limitations on the use of antimicrobial agents in food production (Walia et al., 2019; Kättström et al., 2022; Taylor et al., 2022). In LMICs, where agricultural practices frequently lack control, the unrestrained use of antibiotics in animal production facilitates the emergence of resistant bacteria that may infiltrate the food chain (Samtiya et al., 2022). Due to their limited processing and frequent consumption without additional cooking, RTE foods present an increased risk of the spread of antimicrobial-resistant bacteria among consumers. Furthermore, the use of antimicrobials is affected by AMR, which constitutes a significant global public health and developmental threat. Bacterial AMR is thought to have contributed to 4.95 million fatalities worldwide in 2019 and been directly responsible for 1.27 million deaths (Murray et al., 2022; WHO, 2023).Resistance is a natural occurrence intensified by excessive or improper use (WHO, 2018; Onohuean et al., 2022a; Somda et al., 2023). Followed by mutations, gene transfer, and target modification, antimicrobial-sensitive organisms can develop microbial resistance to antimicrobials (Muteeb et al., 2023; Onohuean and Igere, 2023). Bacteria can increase antibiotic resistance through many processes, which differ according to species and origin. Thought resistance was common among clinical strains, it has become a widespread environmental and food bacterial isolate (Somda et al., 2021); one of the biggest public health issues is global.

Research has revealed a troubling degree of antibiotic resistance in the bacterial pathogens present in these foods, potentially resulting in profound health implications for consumers. The 11 AMR genes included tetracycline (tetA, tetB, tetM), aminoglycoside (aadA, aphA-1), sulphonamide (sulI, sulII), chloramphenicol (cmlA, floR), erythromycin (ermB), and disinfection resistance genes (qacE). TetA has been reported as the most prevalently identified gene in food samples, with a frequency of 100% across all samples (Xiong et al., 2019). Also, the study by Somda et al. (2023) identified tet(A), tet(B), tet(C), tet(K), blaTEM, catA1, catA2, cmlA, blaCTXM, qnrA, qnrB, qnrS, parC, and qepA4 genes as typical in foodborne pathogenic bacteria in West Africa.

The widespread prevalence of antibiotic-resistant pathogenic bacteria in RTE foods significantly contributes to human multidrug resistance. The food chain acts as a transmission route for resistant strains, facilitating the acquisition and of transfer resistance genes, which pose significant health risks. Evidence has shown that multidrug-resistant bacteria in food correlate with the growth of antibiotic-resistant illnesses in humans, thereby complicating treatment (Himanshu et al., 2022; Choy et al., 2024). This underscores the critical need for surveillance data to inform policymakers and stockholders about enhanced food safety protocols. The goal of this scoping review is to create a database for RTE food resistance to antimicrobial drugs in Africa. To identify the most incriminated pathogens, we assessed the evolution of antibiotic resistance in bacteria isolated from RTE food samples and determined the prevalence of antibiotic resistance genes in RTE food.

Microbial contamination is a metric for the efficacy of food safety practices, recognized worldwide as a conduit for pathogen transmission. This scoping review indicated that all the included articles were presented with high population cases of antibiotic-resistant pathogenic bacteria in RTE food at varied degrees of contamination and are classified as unsatisfactory regarding microbiological quality. This findings from several researchers indicate that RTE street foods in the African and resource-limited nations harbour enteric pathogens and is a significant concern to public health system as well reservoir of spread of antibiotic resistance (Oladipo and Adejumobi, 2010; Nyenje et al., 2012; Akinyem et al., 2013; Zige, 2013; Aminu and Umeh, 2014; Akinnibosun and Ojo, 2015; Owoseni and Onilude, 2016; Tesfaye et al., 2016; Yaici et al., 2017; Ananias and Roland, 2017; Ebakota et al., 2018; Morshdy et al., 2018; Okoli et al., 2018; Tshipamba et al., 2018; Blessed, 2018; Ndunguru and Ndossi, 2020; Okafor-Elenwo and Imade, 2020a, 2020b; Okubo et al., 2020; Asiegbu et al., 2020; Claudious et al., 2020; Fayemi et al., 2021; Izevbuwa and Okhuebor, 2021; Makinde et al., 2021; Mayoré et al., 2021; Mekhloufi et al., 2021; Nikiema et al., 2021; Setsoafia Saba et al., 2021; Karikari et al., 2022; Mwove et al., 2022; Soubeiga et al., 2022; Esemu et al., 2023; Alelign et al., 2023; Ronald et al., 2023; Beshiru and Igbinosa, 2023; Akinyele et al., 2024; Isic et al., 2024; Moges et al., 2024; Umar et al., 2024). The notable progress in research concerning antibiotic-resistant pathogenic bacteria in RTE food could be influenced by the significance of the global threat of bacterial resistance and the emergence of infectious pathogens and outbreaks. The greater number of publication funds in Nigeria may be due to the greater number of universities and research institutions in Nigeria compared to other nations. Moreover, the level of educational attainment by the population surpasses that of other countries (Tanko et al., 2020). Other nations have very low research output on antibiotic-resistant pathogenic bacteria in RTE food, which could be elucidated by the fact that most African nations disseminate their research articles in local journals that are not listed or indexed in international databases.

This review underscores the public health risks posed by antibiotic-resistant bacteria in RTE foods, which contribute to foodborne illnesses in Africa. This specific focus on foodborne bacteria is associated with the emergence of resistance reported in environmental domains in recent years by various investigations. The bacteria present in these regions are identical to those associated with food linked to human activity, which may facilitate the development of multidrug-resistant bacteria. Different categories of food commodities have been recognized as highly consumed, as evidenced by the volume of publications concerning RTE food contamination. It can be asserted that food safety information in Africa is inadequate and disjointed, stemming from insufficient surveillance, documentation, and reporting. Furthermore, it reflects and agrees with the report of Paudyal et al. (2017) of poor or inefficient resource utilization, activity duplication, and a lack of synergy among countries in the African region. Our scoping review identified several primary categories of RTE food: chicken or poultry products, meat or beef/beef soup, and animal products and vegetables, including salads, sandwiches, and others. However, animal-derived food, such as poultry and meat products, has been widely identified as a source of illness and infections (Shange et al., 2019; Somda et al., 2023). The presence of enterobacteria in raw vegetable salads is due to their extensive distribution in soil, water, animal and human intestines, and plants. Some enterobacteria are naturally found in vegetable flora (Sagoo et al., 2003; Toe et al., 2017; Somda et al., 2023). At the same time, there are no EU or US criteria for Enterobacteriaceae in salad vegetables, as they naturally present in high quantities.

Epidemiological studies indicate that RTE foods are the primary sources of infectious diseases caused by Campylobacter, Yersinia, E. coli, Salmonella nontyphoidal, and several other pathogens, particularly in low-income nations in Africa. This scoping review indicated that E. coli, Salmonella spp., and Staphylococcus spp. were predominantly responsible for African food contamination during the study period. Most of the articles evaluated indicated that food contamination by microorganisms is associated with inadequate or violations of hygienic regulations in either handling or preparation. Moreover, pathogen-induced food contamination may be associated with the quality of raw materials, water, environment, and the existence of reservoirs and vectors in or next to food production or service locations (Igbinosa et al., 2017; Igere et al., 2022a; Onohuean and Igere, 2022; Onohuean and Nwodo, 2023a).

The public health system in the study region is generally threatened by the consumption of pathogens that contaminate RTE foods. This has been impacted by the increased use of antibiotics, particularly in populations at high risk of illness and life-threatening conditions. Aggravated by the impoverished settings of many African nations, antibiotics are indiscriminately used and sold in public spaces. All these variables significantly contribute to the proliferation of bacterial resistance to antibiotics. Furthermore, adverse economic conditions correlate with malnutrition, lack of access to safe drinking water, and poor hygiene; these are prevalent factors among populations in resource-limited countries that face an increased risk of infection and the transmission of resistant bacteria. In addition, antibiotic-resistant bacteria can infect humans through various situations: indirectly via the food chain through the ingestion of contaminated RTE foods or through direct contact with colonized or infected animals or biological materials such as blood, urine, faeces, saliva, semen, etc. (Cassini et al., 2019).

In this scoping review, E. coli, Salmonella, and Staphylococcus were frequently isolated resistance bacteria and were more implicated in foodborne infectious diseases, in agreement with previous findings (Adefisoye and Okoh, 2016; Igbinosa et al., 2017; Beshiru et al., 2020; Onohuean and Igere, 2022; Beshiru and Igbinosa, 2023). Several antibiotics are engaged in the management of related illnesses, thereby impacting the use of antibiotics and developing resistance to these bacteria. This indicates the overuse of antibiotics in agriculture, veterinary care, and humans. The various analyzed articles indicate the occurrence of genes including tetA, tetB, tetC, and tetK, which confer resistance to tetracycline, as well as blaTEM, catA1, cmlA, blaCTXM, and genes associated with quinolone resistance (qnrA, qnrB, qnrS, parC, and qep), similar to the findings by Igbinosa et al. (2017) and Kimera et al. (2020). However, few studies have reported resistance signatures or gene coding in isolated bacteria. This implies that analytical laboratories in many nations that were examined in this study lack sufficient technology, rendering them unable to identify specific genes associated with antibiotic resistance. Some experts assert that employing sophisticated techniques like whole genome sequencing may enhance the comprehension of the quantity, dissemination, and development of multidrug-resistant organisms.

The proliferation of resistance CTX-M in RTE foods is primarily attributed to human activities, as the majority of E. coli CTX-M, particularly the producer of the enzyme CTX-M-15, circulates clonally, which dominate the dominant faecal E. coli clones in humans, such as ST131, ST95, ST69, ST393, ST405, and ST10 (Sharma et al., 2020; Aworh et al., 2021). Another potential cause of increased antibiotic resistance in RTE food may be linked to resistance genes present in sewage, water or wastewater, soil and environmental indices (Igere et al., 2020, 2024; Onohuean et al., 2021), especially genes such as [aadA, blaOXA, blaOXA, erm (B), erm (F), mef (A), mph (E), sul1, sul3, clust, tet (39), tet (Q), tet (W)]. Interestingly, these wastewater or sewage systems are used for the direct irrigation of crops, particularly in the urban centres of numerous African cities, and are occasionally discharged into streams and rivers that humans and animals ingest in Africa. Studies from different African nations have indicated that Staphylococcus isolated from various sources (pigs, pig carcasses, chicken and handler’s carcasses) carry the mecA gene (Igbinosa et al., 2016; Okoli et al., 2018; Ouoba et al., 2019; Mamfe et al., 2021; Somda et al., 2023). Igbinosa et al. (2016) provided a comprehensive identification of Staphylococci in meat, which is frequently associated with inadequate hygienic measures during slaughtering, shipping, processing, storage, and retail by those engaged in the production process. However, the mecA gene encodes a penicillin-binding protein (PBP2a) that is linked to a markedly reduced affinity for beta-lactams. Its presence induces methicillin resistance in Staphylococcus (Igbinosa et al., 2016; Somda et al., 2023). qacEΔ1 is prevalent for the QAC resistance gene in Gram-negative bacteria and a deletion mutation of qacE (Hrovat et al., 2023).

Furthermore, the selection of antibiotics and patterns of antimicrobial consumption in some geographical locations in Africa are influenced by food, animal species, regional production patterns, types of farming systems (intensive or extensive), farming purposes (commercial, industrial, or domestic), coupled with the absence of a definitive legislative framework or policies regarding antibiotic use, as well as the size and socioeconomic status of the population, particularly among farmers, depicts the finding of the resistance genes. Resistance genes originating from agricultural environments are transferred to human diseases through lateral gene transfer.

In many African nations, antibiotics are readily available, like other over-the-counter drugs (OTC), coupled with self-prescription, resulting in overuse and abuse. Moreover, poverty compels most individuals in low-come settings to purchase cheap antibiotics to treat their ailments rather than incurring expenses from hospitals for proper diagnosis prior to antibiotic treatment. This scoping review indicates that only a limited number of antibiotics remain effective against various infections caused by pathogens. A multitude of reasons may elucidate these findings. Improper regulations for antibiotics, lack of antimicrobial awareness among the population, poor public health facilities in limited resources settings, inadequate and efficient health professionals, poor diagnostics and technological advances, self-health management, etc. The high cost of restricted antibiotics, which are typically regarded as a last resort, is used for critical cases of bacterial infections. Implementing measures to monitor the residual antibiotics that remain effective against these bacterial infections is imperative. As discussed above, the significant factors influencing AMR in Africa include the socioeconomic fallout, such as poverty, inadequate healthcare infrastructure, lack of education and awareness, availability of OTC antibiotics, urbanization, and population.

Our scoping analysis indicated that antibiotic-resistant pathogenic bacteria in RTE food research have not gained comprehensive financing and support from government entities, non-profit organizations, agencies, institutions, universities, commercial corporations, and pharmaceutical businesses. This has also impacted the progress in research and antibiotic epidemiological surveillance in poorly reported African nations. However, interrelationships among donors, funders, policymakers, and support teams are essential for progress, refining strategies, implementing initiatives, promoting stakeholder consultations, as advised by the African community, and ensuring accountability. Furthermore, it is essential to implement a proactive engagement strategy for stakeholders to mitigate the potential threat of bacterial resistance to antibiotics. The lessons from this contribution of this scoping review to the delinquency of multidrug resistance imply that the presence of antibiotic-resistant pathogenic bacteria in RTE foods considerably worsens the problem of multidrug resistance (MDR). The existence of these bacteria not only presents a direct health hazard but also enables the transmission of resistance genes to human infections, thereby complicating therapeutic alternatives. For instance, 43.5% of coagulase-negative staphylococci (CoNS) strains remained identified as multidrug-resistant (Chajęcka-Wierzchowska et al., 2023), and more than 95% of E. coli bacteria from RTE foods exhibited multidrug resistance, demonstrating elevated resistance levels to prevalent medicines such as tetracycline and ampicillin (Zhang et al., 2021; Onohuean and Igere, 2022). Of significant importance, the mobile genetic elements (MGEs) essential for the horizontal transfer of antibiotic resistance genes have been identified in Enterococcus faecium UC7251, which is isolated from RTE food and contains plasmids that enable the transfer of resistance genes (Belloso Daza et al., 2022). The existence of plasmid-mediated colistin resistance in E. coli underscores the capacity of these genes to disseminate swiftly from bacterial to human populations (Zhang et al., 2021).

AMR is associated with increased morbidity and mortality, with forecasts indicating up to 10 million fatalities per year by 2050 if current trends persist (Tang et al., 2023). Globally, AMR has become a critical global health issue, with increasing resistance to commonly used antibiotics threatening to undermine advances in medicine. Global trends in AMR reflect a rise in infections caused by resistant bacteria, driven by factors such as the overuse and misuse of antibiotics in healthcare and agriculture, poor sanitation, and inadequate infection control measures (WHO, 2023). Studies have shown that resistance is not confined to any region but is a global phenomenon affecting both high-income countries (e.g., the US and Europe) and low- and middle-income countries (LMICs) (Samtiya et al., 2022; Salam et al., 2023). In LMICs, the situation is often exacerbated by limited access to effective antibiotics, weak regulatory frameworks, and insufficient public health infrastructure (Salam et al., 2023). The RTE food industry has emerged as a significant pathway for the transmission of resistant pathogens, with studies suggesting that foodborne bacteria, particularly from animal products, can contribute to the spread of AMR (Conceição et al., 2023; Grudlewska-Buda et al., 2023; Ronald et al., 2023). Global surveillance data from WHO and the Centers for Disease Control and Prevention (CDC) indicate widespread resistance, especially to common pathogens like E. coli, Salmonella, and Staphylococcus aureus (WHO, 2020; Murray et al., 2022). This is compounded by the slow development of new antibiotics, creating an urgent need for more substantial prevention, monitoring, and treatment strategies across the food, healthcare, and environmental sectors. In addition, the financial ramifications of AMR are significant, with potential losses reaching trillions of dollars attributable to healthcare expenditures and diminished productivity (Ahmed et al., 2024), with a more significant consequence in low-income nations in their already poor and over-stressed medical health systems.

Going forward, a single health approach that involving an integrated interdisciplinary approach encompassing human, animal, and environmental health is crucial for efficient antimicrobial resistance management. Lessons learned from the four successful nations of Denmark, the United Kingdom (UK), the Netherlands, and Sweden on AMR mitigation strategies could strengthen and impact positive African outcomes. For instance, Denmark and Sweden’s strategy for AMR emphasized stringent rules governing antibiotic use in humans and animals (Levy, 2014; Wierup et al., 2021; Regeringskansliet, 2024; Wu, 2024). Denmark implemented policies to limit the use of antibiotics for growth promotion in animals, combined with surveillance programs to monitor antibiotic consumption and resistance patterns. The UK has an AMR policy that covers healthcare, agriculture, and the environment. The “UK Five-Year Action Plan for AMR” promotes antibiotic alternatives in agriculture, stewardship, and public awareness. This method has greatly reduced the number of human antibiotic prescriptions and associated resistance (Blake et al., 2022). Whereas, the Netherlands leverage on “One Health” approach to AMR by integrating human, animal, and environmental health sectors. By reducing antibiotic use in both human medicine and livestock, and by promoting alternative therapies, the country has reduced AMR, particularly in farm animals (Ooms et al., 2023). Therefore, stockholders in the African region must develop and implement short-, medium-, and long-term strategies that encompass one health approach. Furthermore, improving public awareness and education about AMR determinants and advocating for regulations on ethical antibiotic use are essential for addressing this problem. Other actionable recommendations for policymakers include establishing or improving national and global AMR surveillance networks to monitor AMR trends in humans, animals, and food products. Moreover, given the global nature of AMR, international cooperation is essential. Policymakers should collaborate through frameworks like the WHO’s Global Action Plan on AMR to ensure consistent policies and shared resources. Policymakers should incentivize public-private partnerships to accelerate innovation in combating resistant pathogens. Increased funding for developing vaccines, new antibiotics, alternative treatments (e.g., bacteriophages), and diagnostic tools is crucial.

In this scoping review, some African nations were poorly represented in the antibiotic-resistant pathogenic bacteria survey following the article’s inclusion criteria and used databases. However, it increased the pathogens primarily responsible for foodborne infections, namely E. coli, Salmonella, and Staphylococcus. Educating food vendors and operators about proper hygiene practices can be a practical and cost-effective solution. The scoping analysis revealed that various forms of antibiotic resistance have been documented in food commodities across multiple African countries, with significant levels of resistance observed in infectious pathogens in diverse RTE foods. The regional antibiotic resistance surveillance system is a significant concern. Therefore, the use of antibiotics in agriculture, the food industry, and human health requires stringent regulations in Africa, particularly in resource-limited settings. This highlights the urgent need for effective control strategies to reduce the spread of resistant bacteria in RTE foods.