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

Ziad Jaradat; Batool Khataybeh; Qutaiba Ababneh; Anas Al Nabulsi; Ragad Musa; Lamice Shurafa; Nisrina Ali; Maram Zahrawi; Farah Harbieh; Jude Nassar; Abeer Idrees; Bara'ah Eyadat; Ekhlas Al-Rousan; Ziad Jaradat; Batool Khataybeh; Qutaiba Ababneh; Anas Al Nabulsi; Ragad Musa; Lamice Shurafa; Nisrina Ali; Maram Zahrawi; Farah Harbieh; Jude Nassar; Abeer Idrees; Bara'ah Eyadat; Ekhlas Al-Rousan

doi:10.3934/publichealth.2026012

AIMS Public Health

2026, Volume 13, Issue 1: 204-221. doi: 10.3934/publichealth.2026012

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

1.
Department of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, P. O Box, 3030, Irbid, Jordan
2.
Department of Nutrition and Food Technology, Jordan University of Science and Technology, P. O Box, 3030, Irbid, Jordan

Received: 24 August 2025 Revised: 16 November 2025 Accepted: 09 December 2025 Published: 03 February 2026

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.
- shopping carts,
- ESKAPE pathogens,
- environmental contamination,
- MRSA,
- VRE,
- community transmission
Citation: Ziad Jaradat, Batool Khataybeh, Qutaiba Ababneh, Anas Al Nabulsi, Ragad Musa, Lamice Shurafa, Nisrina Ali, Maram Zahrawi, Farah Harbieh, Jude Nassar, Abeer Idrees, Bara'ah Eyadat, Ekhlas Al-Rousan. Assessing the public health risk from ESKAPE pathogens including MRSA and VRE on high-touch shopping cart surfaces[J]. AIMS Public Health, 2026, 13(1): 204-221. doi: 10.3934/publichealth.2026012

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Abstract

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.

Acknowledgments

This work was funded by the deanship of research at Jordan University of Science and Technology (grant no. 2024/502).

Authors' contributions

ZJ: Conceptualization, Funding acquisition, Supervision, Writing - review & editing; BK: Data curation, Formal analysis, Methodology, Writing - original draft; QA: Supervision, Formal analysis, Writing - review & editing; AA: Formal analysis; RM: Formal analysis, Methodology, Writing - original draft; LS: Formal analysis, Methodology; NA: Formal analysis, Methodology; MZ: Formal analysis, Methodology; FH: Formal analysis, Methodology; JN: Formal analysis, Methodology; AI: Formal analysis, Methodology; BE: Formal analysis, Methodology; EA: Formal analysis, Data curation, Writing - original draft. The authors read and approved the final manuscript.

Conflicts of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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