Prevalence of methicillin-resistant staphylococcus aureus in healthy population in China: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Xue ¹ , LI Xiaobo ² , HAN Jing ² , XU Li ¹ , ZOU Linlin ¹ , WANG Jin ¹ , HU Zhong ¹ ,  ZHENG Juan ¹

1. Department of Respiratory Medicine, The First People’s Hospital of Chongqing Liang Jiang New Area, Chongqing, 401121, P.R.China;
2. Department of Respiratory Medicine, Chengdu Seventh People’s Hospital, Chengdu, 610000, P.R.China;
3. Department of Respiratory and Critical Care Medicine, Gui Zhou Provincial People’s Hospital, Guiyang, 550002, P.R.China;

Corresponding?author：

ZHENG Juan, Email: zhengjuanlx@163.com

Keywords：

China; Healthy population; MRSA; Prevalence; Meta-analysis; Cross-sectional study

DOI：

10.7507/1672-2531.201904042

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives To systematically review the prevalence of methicillin-resistant staphylococcus aureus (MRSA) in healthy Chinese population.Methods PubMed, EMbase, WanFang Data and CNKI databases were electronically searched to collect cross-sectional studies of the prevalence of MRSA in China from inception to December 16^th, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, and then, meta-analysis was performed by using Stata 12.0 software.Results A total of 25 cross-sectional studies were included. The results of meta-analysis showed that: the pooled prevalence of MRSA in healthy population was 13.9% (95%CI 9.6% to 18.2%). The results of subgroup analysis showed that: the prevalence of MRSA in children was 16% (95%CI 8% to 24%), and that in adults (non-children) was 13% (95%CI 9% to 16%). The prevalence of MRSA in individuals with occupational livestock exposure was 28% (95%CI 5% to 51%), in medical staff it was 16% (95%CI 8% to 25%), in medical students it was 12% (95%CI 3% to 20%) and in community residents it was 5% (95%CI 2% to 8%).Conclusions The overall prevalence of MRSA in healthy Chinese population is approximately 13.9%. Effective prevention and control measures are required to reduce the spread of MRSA.

Citation： YANG Xue, LI Xiaobo, HAN Jing, XU Li, ZOU Linlin, WANG Jin, HU Zhong, ZHENG Juan. Prevalence of methicillin-resistant staphylococcus aureus in healthy population in China: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(9): 1037-1043. doi: 10.7507/1672-2531.201904042 Copy

1.	Sahreena L, Zhang KY. Methicillin-resistant staphylococcus aureus: molecular characterization, evolution, and epidemiology. Clin Microbiol Rev, 2018, 31(4): 12.
2.	Hurley JC. Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: a meta-analysis. Med J Aust, 2002, 176(4): 188-189.
3.	趙旺旺. 耐甲氧西林金黃色葡萄球菌的研究進展. 社區醫學雜志, 2006, 11(5): 78-80.
4.	Chen CJ, Hsu KH, Lin TY, et al. Factors associated with nasal colonization of methicillin-resistant Staphylococcus aureus among healthy children in Taiwan. J Clin Microbiol, 2011, 49(1): 131-137.
5.	Huang YC, Ho CF, Chen CJ, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus in household contacts of children with community-acquired diseases in Taiwan. Pediatr Infect Dis J, 2007, 26(11): 1066-1068.
6.	Boyle MH. Guidelines for evaluating prevalence studies. Evid Based Ment Heal, 1998, 1(2): 37-39.
7.	Laird N. Meta-analysis in clinical trials. Control Clin Trials, 1986, 7(3): 177.
8.	Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
9.	Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4): 1088-1101.
10.	Seagroatt V, Stratton I. Bias in meta-analysis detected by a simple, graphical test. Test had 10% false positive rate. BMJ, 1998, 316(7219): 470-470.
11.	Ye X, Liu W, Fan Y, et al. Frequency-risk and duration-risk relations between occupational livestock contact and methicillin-resistant Staphylococcus aureus carriage among workers in Guangdong, China. Am J Infect Control, 2015, 43(7): 676-681.
12.	范娟, 周偉, 舒敏, 等. 成都地區健康兒童鼻腔社區獲得性耐甲氧西林金黃色葡萄球菌的攜帶研究. 中國當代兒科雜志, 2011, 13(1): 16-19.
13.	Zhang W, Hao Z, Wang Y, et al. Molecular characterization of methicillin-resistant Staphylococcus aureus strains from pet animals and veterinary staff in China. Vet J, 2011, 190(2): e125-e129.
14.	Ma XX, Sun DD, Wang S, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus among preclinical medical students: epidemiologic and molecular characteristics of methicillin-resistant S. aureus clones. Diagn Microbiol Infect Dis, 2011, 70(1): 22-30.
15.	馬笑雪, 羅恩杰. 社區分離金黃色葡萄球菌在健康人群中的分布及其分子生物學特點. 中華流行病學雜志, 2011, 32(8): 804-807.
16.	Chen B, Dai X, He B, et al. Differences in Staphylococcus aureus nasal carriage and molecular characteristics among community residents and healthcare workers at Sun Yat-Sen University, Guangzhou, Southern China. BMC Infect Dis, 2015, 15(1): 303.
17.	Du J, Chen C, Ding B, et al. Molecular characterization and antimicrobial susceptibility of nasal Staphylococcus aureus isolates from a Chinese medical college campus. PLoS One, 2011, 6(11): e27328.
18.	O'Donoghue MM, Boost MV. The prevalence and source of methicillin-resistant Staphylococcus aureus (MRSA) in the community in HongKong. Epidemiol Infect, 2004, 132(6): 1091-1097.
19.	Xie X, Dai X, Ni L, et al. Molecular epidemiology and virulence characteristics of Staphylococcus aureus nasal colonization in medical laboratory staff: comparison between microbiological and non-microbiological laboratories. BMC Infect Dis, 2018, 18(1): 122.
20.	Yan X, Song Y, Yu X, et al. Factors associated with Staphylococcus aureus nasal carriage among healthy people in Northern China. Clin Microbiol Infect, 2015, 21(2): 157-162.
21.	Chen BJ, Xie XY, Ni LJ, et al. Factors associated with Staphylococcus aureus nasal carriage and molecular characteristics among the general population at a Medical College Campus in Guangzhou, South China. Ann Clin Microbiol Antimicrob, 2017, 16(1): 28.
22.	Chen CH, Kuo KC, Hwang KP, et al. Risk factors for and molecular characteristics of methicillin-resistant Staphylococcus aureus nasal colonization among healthy children in southern Taiwan, 2005-2010. DOI: 10.1016/j.jmii.2018.09.003.
23.	鄧建軍, 萬朝敏, 母得志, 等. 在校健康兒童鼻前庭攜帶金黃色葡萄球菌檢測及藥物敏感分析. 四川大學學報(醫學版), 2012, 43(3): 391-394.
24.	Zhang M, O'Donoghue MM, Ito T, et al. Prevalence of antiseptic-resistance genes in Staphylococcus aureus and coagulase-negative staphylococci colonising nurses and the general population in Hong Kong. J Hosp Infect, 2011, 78(2): 113-117.
25.	Ho PL, Chiu SS, Chan MY, et al. Molecular epidemiology and nasal carriage of Staphylococcus aureus and methicillin-resistant S. aureus among young children attending day care centers and kindergartens in Hong Kong. J Infect, 2012, 64(5): 500-506.
26.	Gong Z, Shu M, Xia Q, et al. Staphylococcus aureus nasal carriage and its antibiotic resistance profiles in children in high altitude areas of Southwestern China. Arch Argent Pediatr, 2017, 115(3): 274-277.
27.	Boost MV, So SY, Perreten V. Low rate of methicillin-resistant coagulase-positive staphylococcal colonization of veterinary personnel in Hong Kong. Zoonoses Public Health, 2011, 58(1): 36-40.
28.	傅錦堅, 葉小華, 姚振江, 等. 健康兒童鼻攜帶金黃色葡萄球菌耐藥性研究. 現代預防醫學, 2015, 42(12): 2175-2177.
29.	葛憶琳, 陳越火, 朱仁義, 等. 醫護人員攜帶MRSA及其耐藥基因的研究. 中國消毒學雜志, 2012, 29(7): 565-568.
30.	劉賀, 費春楠, 董杰, 等. 醫護人員鼻前庭帶菌情況及其耐藥性研究. 中國消毒學雜志, 2016, 33(10): 983-985, 988.
31.	鐘嘉冀, 張川, 賴莉莉, 等. 乳肉加工銷售人員中耐甲氧西林金黃色葡萄球菌的攜帶與耐藥情況分析. 中華醫院感染學雜志, 2016, 26(23): 5315-5317.
32.	陳百計, 姚澤宇, 代鑫露, 等. 廣州社區人群金黃色葡萄球菌鼻腔攜帶調查和分子流行特征. 熱帶醫學雜志, 2017, 17(12): 1583-1588.
33.	Huang YC, Hwang KP, Chen PY, et al. Prevalence of methicillin-resistant Staphylococcus aureus nasal colonization among Taiwanese children in 2005 and 2006. J Clin Microbiol, 2007, 45(12): 3992-3995.
34.	Lu PL, Chin LC, Peng CF, et al. Risk factors and molecular analysis of community methicillin-resistant Staphylococcus aureus carriage. J Clin Microbiol, 2005, 43(1): 132-139.
35.	胡付品, 朱德妹, 汪復, 等. 2014年CHINET中國細菌耐藥性監測. 中國感染與化療雜志, 2015, (5): 401-410.
36.	den Heijer CD, van Bijnen EM, Paget WJ, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis, 2013, 13(5): 409-415.
37.	Ma E, Wong S, Wong C, et al. Effects of public health interventions in reducing transmission of hand, foot, and mouth disease. Pediatr Infect Dis J, 2011, 30(5): 432-435.
38.	Dulon M, Peters C, Schablon A, et al. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: a systematic review. BMC Infect Dis, 2014, 14: 363.
39.	Bitterman Y, Laor A, Itzhaki S, et al. Characterization of the best anatomical sites in screening for methicillin-resistant Staphylococcus aureus colonization. Eur J Clin Microbiol Infect Dis, 2010, 29(4): 391-397.

1. Sahreena L, Zhang KY. Methicillin-resistant staphylococcus aureus: molecular characterization, evolution, and epidemiology. Clin Microbiol Rev, 2018, 31(4): 12.
2. Hurley JC. Risk of death from methicillin-resistant Staphylococcus aureus bacteraemia: a meta-analysis. Med J Aust, 2002, 176(4): 188-189.
3. 趙旺旺. 耐甲氧西林金黃色葡萄球菌的研究進展. 社區醫學雜志, 2006, 11(5): 78-80.
4. Chen CJ, Hsu KH, Lin TY, et al. Factors associated with nasal colonization of methicillin-resistant Staphylococcus aureus among healthy children in Taiwan. J Clin Microbiol, 2011, 49(1): 131-137.
5. Huang YC, Ho CF, Chen CJ, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus in household contacts of children with community-acquired diseases in Taiwan. Pediatr Infect Dis J, 2007, 26(11): 1066-1068.
6. Boyle MH. Guidelines for evaluating prevalence studies. Evid Based Ment Heal, 1998, 1(2): 37-39.
7. Laird N. Meta-analysis in clinical trials. Control Clin Trials, 1986, 7(3): 177.
8. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
9. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4): 1088-1101.
10. Seagroatt V, Stratton I. Bias in meta-analysis detected by a simple, graphical test. Test had 10% false positive rate. BMJ, 1998, 316(7219): 470-470.
11. Ye X, Liu W, Fan Y, et al. Frequency-risk and duration-risk relations between occupational livestock contact and methicillin-resistant Staphylococcus aureus carriage among workers in Guangdong, China. Am J Infect Control, 2015, 43(7): 676-681.
12. 范娟, 周偉, 舒敏, 等. 成都地區健康兒童鼻腔社區獲得性耐甲氧西林金黃色葡萄球菌的攜帶研究. 中國當代兒科雜志, 2011, 13(1): 16-19.
13. Zhang W, Hao Z, Wang Y, et al. Molecular characterization of methicillin-resistant Staphylococcus aureus strains from pet animals and veterinary staff in China. Vet J, 2011, 190(2): e125-e129.
14. Ma XX, Sun DD, Wang S, et al. Nasal carriage of methicillin-resistant Staphylococcus aureus among preclinical medical students: epidemiologic and molecular characteristics of methicillin-resistant S. aureus clones. Diagn Microbiol Infect Dis, 2011, 70(1): 22-30.
15. 馬笑雪, 羅恩杰. 社區分離金黃色葡萄球菌在健康人群中的分布及其分子生物學特點. 中華流行病學雜志, 2011, 32(8): 804-807.
16. Chen B, Dai X, He B, et al. Differences in Staphylococcus aureus nasal carriage and molecular characteristics among community residents and healthcare workers at Sun Yat-Sen University, Guangzhou, Southern China. BMC Infect Dis, 2015, 15(1): 303.
17. Du J, Chen C, Ding B, et al. Molecular characterization and antimicrobial susceptibility of nasal Staphylococcus aureus isolates from a Chinese medical college campus. PLoS One, 2011, 6(11): e27328.
18. O'Donoghue MM, Boost MV. The prevalence and source of methicillin-resistant Staphylococcus aureus (MRSA) in the community in HongKong. Epidemiol Infect, 2004, 132(6): 1091-1097.
19. Xie X, Dai X, Ni L, et al. Molecular epidemiology and virulence characteristics of Staphylococcus aureus nasal colonization in medical laboratory staff: comparison between microbiological and non-microbiological laboratories. BMC Infect Dis, 2018, 18(1): 122.
20. Yan X, Song Y, Yu X, et al. Factors associated with Staphylococcus aureus nasal carriage among healthy people in Northern China. Clin Microbiol Infect, 2015, 21(2): 157-162.
21. Chen BJ, Xie XY, Ni LJ, et al. Factors associated with Staphylococcus aureus nasal carriage and molecular characteristics among the general population at a Medical College Campus in Guangzhou, South China. Ann Clin Microbiol Antimicrob, 2017, 16(1): 28.
22. Chen CH, Kuo KC, Hwang KP, et al. Risk factors for and molecular characteristics of methicillin-resistant Staphylococcus aureus nasal colonization among healthy children in southern Taiwan, 2005-2010. DOI: 10.1016/j.jmii.2018.09.003.
23. 鄧建軍, 萬朝敏, 母得志, 等. 在校健康兒童鼻前庭攜帶金黃色葡萄球菌檢測及藥物敏感分析. 四川大學學報(醫學版), 2012, 43(3): 391-394.
24. Zhang M, O'Donoghue MM, Ito T, et al. Prevalence of antiseptic-resistance genes in Staphylococcus aureus and coagulase-negative staphylococci colonising nurses and the general population in Hong Kong. J Hosp Infect, 2011, 78(2): 113-117.
25. Ho PL, Chiu SS, Chan MY, et al. Molecular epidemiology and nasal carriage of Staphylococcus aureus and methicillin-resistant S. aureus among young children attending day care centers and kindergartens in Hong Kong. J Infect, 2012, 64(5): 500-506.
26. Gong Z, Shu M, Xia Q, et al. Staphylococcus aureus nasal carriage and its antibiotic resistance profiles in children in high altitude areas of Southwestern China. Arch Argent Pediatr, 2017, 115(3): 274-277.
27. Boost MV, So SY, Perreten V. Low rate of methicillin-resistant coagulase-positive staphylococcal colonization of veterinary personnel in Hong Kong. Zoonoses Public Health, 2011, 58(1): 36-40.
28. 傅錦堅, 葉小華, 姚振江, 等. 健康兒童鼻攜帶金黃色葡萄球菌耐藥性研究. 現代預防醫學, 2015, 42(12): 2175-2177.
29. 葛憶琳, 陳越火, 朱仁義, 等. 醫護人員攜帶MRSA及其耐藥基因的研究. 中國消毒學雜志, 2012, 29(7): 565-568.
30. 劉賀, 費春楠, 董杰, 等. 醫護人員鼻前庭帶菌情況及其耐藥性研究. 中國消毒學雜志, 2016, 33(10): 983-985, 988.
31. 鐘嘉冀, 張川, 賴莉莉, 等. 乳肉加工銷售人員中耐甲氧西林金黃色葡萄球菌的攜帶與耐藥情況分析. 中華醫院感染學雜志, 2016, 26(23): 5315-5317.
32. 陳百計, 姚澤宇, 代鑫露, 等. 廣州社區人群金黃色葡萄球菌鼻腔攜帶調查和分子流行特征. 熱帶醫學雜志, 2017, 17(12): 1583-1588.
33. Huang YC, Hwang KP, Chen PY, et al. Prevalence of methicillin-resistant Staphylococcus aureus nasal colonization among Taiwanese children in 2005 and 2006. J Clin Microbiol, 2007, 45(12): 3992-3995.
34. Lu PL, Chin LC, Peng CF, et al. Risk factors and molecular analysis of community methicillin-resistant Staphylococcus aureus carriage. J Clin Microbiol, 2005, 43(1): 132-139.
35. 胡付品, 朱德妹, 汪復, 等. 2014年CHINET中國細菌耐藥性監測. 中國感染與化療雜志, 2015, (5): 401-410.
36. den Heijer CD, van Bijnen EM, Paget WJ, et al. Prevalence and resistance of commensal Staphylococcus aureus, including meticillin-resistant S aureus, in nine European countries: a cross-sectional study. Lancet Infect Dis, 2013, 13(5): 409-415.
37. Ma E, Wong S, Wong C, et al. Effects of public health interventions in reducing transmission of hand, foot, and mouth disease. Pediatr Infect Dis J, 2011, 30(5): 432-435.
38. Dulon M, Peters C, Schablon A, et al. MRSA carriage among healthcare workers in non-outbreak settings in Europe and the United States: a systematic review. BMC Infect Dis, 2014, 14: 363.
39. Bitterman Y, Laor A, Itzhaki S, et al. Characterization of the best anatomical sites in screening for methicillin-resistant Staphylococcus aureus colonization. Eur J Clin Microbiol Infect Dis, 2010, 29(4): 391-397.

Previous Article
The association between pepper consumption and gastric cancer: a meta-analysis
Next Article
The prognostic value of plasma sTREM-1 in predicting 28-day mortality in sepsis: a systematic review

Chinese Journal of Evidence-Based Medicine

Prevalence of methicillin-resistant staphylococcus aureus in healthy population in China: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content