Assessing the public health risk from ESKAPE pathogens including MRSA and VRE on high-touch shopping cart surfaces

Increased antimicrobial resistance (AMR) poses a significant threat to global health. This study investigated the prevalence, antibiotic susceptibility, and biofilm-forming ability of ESKAPE pathogens on shopping cart handles in Jordan. Swab samples were collected from 820 shopping carts used in grocery stores, and ESKAPE bacteria were identified using microbiological and molecular methods. The most prevalent species isolated was Staphylococcus aureus, which was recovered from 4.8% of the samples, followed by Acinetobacter baumannii (2.1%), Escherichia coli (2%), and Enterococcus spp. (0.73%). Most isolates were sensitive to antibiotics, though two E. faecium isolates showed resistance to vancomycin (VRE), and 17 S. aureus isolates were methicillin-resistant (MRSA). The ability of the isolates to form biofilm varied, with most S. aureus being non-formers (53.8%), whereas A. baumannii isolates were predominantly strong formers (53%). The presence of ESKAPE pathogens, including clinically significant strains like MRSA and VRE, on frequently touched shopping cart handles highlights the role played by these surfaces as potential reservoirs for transmission in the community.