Dominance of Bacillus cereus and Staphylococcus aureus in Foodborne Outbreaks: A 19-Year Systematic Review of Surveillance Data in Yogyakarta, Indonesia.

BACKGROUND/OBJECTIVES: Foodborne diseases account for the majority of infectious disease outbreaks in Yogyakarta, Indonesia, yet remain underexplored epidemiologically. This systematic review aimed to characterize the epidemiological patterns and risk factors of foodborne disease outbreaks in this region between 2006 and 2024. METHODS: This systematic review searched electronic databases and grey literature published between 1 January 2006 and 31 December 2024. Eligible studies were reported in English or Indonesian and used descriptive or environmental observational designs. Methodological quality was assessed using a modified Joanna Briggs Institute (JBI) checklist. Searching, screening, and data coding were performed independently by the reviewers. The review followed PRISMA reporting guidelines and was registered with PROSPERO (CRD420251060794). RESULTS: Of 841 studies screened, 99 met the inclusion criteria. The most frequently identified pathogens were Bacillus cereus (43.43%) and Staphylococcus aureus (34.34%), associated with 101 and 97 hospitalizations, respectively. Improper post-cooking storage (77.00%) was the leading contributing factor for Bacillus cereus outbreaks, whereas unsafe food processing practices (76.00%) predominated for Staphylococcus aureus outbreaks. Individual unregistered catering services accounted for the largest proportion of outbreaks. CONCLUSIONS: Public health strategies should prioritize strengthening food handlers' capacity during food processing and post-cooking storage, particularly among individual informal catering services, to sharpen foodborne disease control efforts in Yogyakarta.