| Summary: | World Health Organization (WHO) stated that the burden of foodborne disease achieves
600 million cases each year with one of ten people in the world falls ill after consuming
contaminated food. In Malaysia along, food poisoning cases were occupied 15,023 cases
in 2018. The foodborne illness is associated with poor handling of cooked food by the
food handlers rather than cross-contamination from raw food in food premises. This
study aimed to (i) determine the prevalence of both S. aureus hand carriers and
methicillin resistant S. aureus (MRSA) strains among food handlers and in cooked food,
(ii) identify the correlation between the socio-demographic characteristics profile of the
food handlers with the prevalence and multidrug resistant (MDR) S. aureus strains
among food handlers, and (iii) evaluate the epidemiological relationship among S. aureus
strains obtained from food handlers’ hands and cooked food samples. Two hundreds
hand swab samples with 100 cooked food samples were collected from Grade A, B, and
C food premises throughout Klang Valley which socio-demographic information of food
handlers was recorded. Several analyses were performed to detect the presence of S.
aureus and MRSA, such as mannitol salt agar test, biochemical tests, and antimicrobial
susceptibility test. DNA extraction and polymerase chain reaction (PCR) analysis for
phylogenetic sequence analysis were further performed. Statistical analysis was done by
using the software IBM SPSS Statistic 22. The results showed that the prevalence of S.
aureus among food handlers and cooked food were 95.0% and 50.0%, respectively. None
of the food handlers inhered MRSA strains with four (8.0%) cooked food samples were
detected with MRSA strains. Further Fisher-Freeman Halton analysis revealed that there
was no significant correlation between food handlers’ socio-demographic profile and the
prevalence of S. aureus. The occupational information and lifestyle habits of food
handlers, however, were correlated to the prevalence of S. aureus. The grading system
authorized by local authorities (P = 0.000), grades of food premises (P = 0.010), years
of employment (P = 0.049) and working responsibility (P = 0.026) of food handlers were
significantly correlated with the prevalence of S. aureus. Nonetheless, no correlation was
found between MDR S. aureus with the socio-demography profile, occupational
information and lifestyle habits of food handlers. On the other hand, PCR molecular
analysis identified that the overall prevalence of S. aureus and MRSA among food
handlers was 25.0% and 1.0%, respectively. For cooked food samples, the prevalence of
S. aureus was 9.0%. The further phylogenetic tree sequencing analysis showed that most
of the cooked food samples had different similarities with the food handlers’ S. aureus
strains. However, there was epidemiological relationship between food handler (HL11)
and cooked food (F11) which the current study assumed that cross contamination from
food handler to food was occurred during food preparation. This urges for the
improvements in constructive and sustainable food safety practises among food handlers
to reduce the risk of foodborne illness outbreaks.
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