Abstract
Background and rationale: Staphylococcus aureus fecal carriage has been identified as a potential source for nosocomial transmission and a risk factor for disease development. This systematic review determined the overall S. aureus [including methicillin susceptible and resistant S. aureus (MSSA and MRSA)] fecal carriage rates within the community and healthcare settings.Methodology: Peer-reviewed articles indexed in Medline, Scopus, Academic Search Premier, Africa-Wide Information, CINAHL, and Web of Science were identified using applicable and controlled vocabulary through to 11 November 2015. Eligible studies were ascertained by three independent reviewers. Random-effects meta-analyses of proportions were performed to determine S. aureus, MSSA and MRSA fecal carriage rates reported by eligible studies.Results: Twenty six studies were included in this review. The pooled estimates for S. aureus, MSSA and MRSA fecal carriage were 26% (95% confidence interval (CI): 16.8–36.3%), 86% (95% confidence interval (CI): 65.9–97.9%) and 10% (95% CI: 0.7–27.0%), respectively. Fecal S. aureus carriage rates increased on average from 10 to 65% during the first 8 weeks of life, followed by an average carriage rate of 64% at 6 months and 46% at 1 year of life. Genotyping techniques were employed mainly in studies conducted in developed countries and comprised largely of gel-based techniques. Six studies reported on the role of S. aureus fecal strains in diarrhea (n = 2) and the risk for acquiring infections (n = 4). Eight of the 26 studies included in this review performed antibiotic susceptibility testing of S. aureus fecal isolates.Conclusion: This study provides evidence that screening for S. aureus fecal carriage, at least in populations at high risk, could be an effective measure for the prevention of S. aureus transmission and infection in the healthcare and community setting. More well-structured studies need to be conducted and sequence-based genotyping techniques should be employed for the comparison of isolates on a global scale in both developing and developed countries.
Highlights
Staphylococcus aureus is a commensal Gram-positive bacterium, which under certain circumstances may be responsible for pyogenic or toxigenic infections, such as skin and soft tissue infections, toxic shock syndrome and pneumonia (Tong et al, 2015)
Healthcare Setting In-patients Patients screened for S. aureus or methicillin-resistant S. aureus (MRSA) fecal carriage with >48 h of healthcare contact
Healthcare personnel Participants screened for S. aureus or MRSA fecal carriage working at a healthcare setting with or without any illness
Summary
Staphylococcus aureus is a commensal Gram-positive bacterium, which under certain circumstances may be responsible for pyogenic or toxigenic infections, such as skin and soft tissue infections, toxic shock syndrome and pneumonia (Tong et al, 2015). Thereafter, several studies have provided evidence on the clinical importance of fecal carriage of S. aureus [in particular methicillin-resistant S. aureus (MRSA)] in the hospital setting (Acton et al, 2009). It has been shown that hospitalized patients with both S. aureus fecal and nasal colonization are significantly more likely to have positive skin cultures compared to patients with nasal carriage only (Bhalla et al, 2007). S. aureus fecal carriage may serve as an important source for environmental contamination, which can potentially facilitate nosocomial transmission within the healthcare setting (Bhalla et al, 2007). Staphylococcus aureus fecal carriage has been identified as a potential source for nosocomial transmission and a risk factor for disease development. This systematic review determined the overall S. aureus [including methicillin susceptible and resistant S. aureus (MSSA and MRSA)] fecal carriage rates within the community and healthcare settings
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