Prevalence of Staphylococcus aureus in Traditional Ice Cream in Iran: A Systematic Review and Meta-analysis

Staphylococcus aureus is known to be the third leading cause of food poisoning in the world. Traditional ice cream is one of the dairy products in Iran and some countries in the world that should be controlled for Staphylococcus aureus contamination. The purpose of this review and meta-analysis is to determine the contamination of traditional ice cream with Staphylococcus aureus in different regions of Iran. Search terms “Staphylococcus aureus”, “traditional ice Cream”, and “Iran” were used in Science Direct, Pubmed, Scopus, Google Scholar, and SID, Magiran Magazine until 2018 published without time limitation selected. To review the original articles and remove duplicate articles and review titles and abstracts, articles that have the required qualities for this research were studied in this study. Data were analyzed by the random effects model in STATA (version 11) and MedCalc (version 13) software. Publication bias and sensitivity analysis were assessed by funnel and influence plots. According to a sample size of 3811 from 35 articles, the prevalence of Staphylococcus aureus is estimated 32% in Iran (95% CI: 25-38%, p<0.001). The heterogeneity in the estimation of the pooled prevalence among the studies demonstrated; Cochran Q test: 1577.39, p< 0.001, I2 = 97.84%. Based on Begg's adjusted rank correlation test, publication bias was statistically significant (p <0.05). Epidemiological data is useful to determine the distribution of Staphylococcus aureus contamination and provide a broad picture of the prevalence of traditional ice cream Iran and can be used as an important indicator in the model of risk assessment of microbiologic.