Abstract
ObjectiveTo determine the pooled prevalence and review the influencing factors of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization in Chinese children.MethodsArticles published between January 2005 and October 2015 that studied prevalence or influencing factors of MRSA nasal colonization in Chinese children were retrieved from Chinese Biomedical Literature database (CBM), China National Knowledge Infrastructure (CNKI) database, Chinese VIP database, Chinese Wanfang database, Medline database and Ovid database. Prevalence and influencing factors were analyzed by STATA 13.1.ResultsThirteen articles were included. The overall prevalence of MRSA nasal colonization was 4.4% (95% confidence interval [CI]: 0.027–0.062). With an MRSA prevalence of 3.9% (95% CI: 0.018–0.061) in healthy children and 5.8% (95% CI: 0.025–0.092) in children with underlying medical conditions. Children recruited in the hospitals presented MRSA prevalence of 6.4% (95% CI: 0.037–0.091), which was higher than those recruited in the communities [2.7% (95% CI: 0.012–0.043)]. A number of influencing factors for MRSA nasal colonization were noted in three eligible studies: gender (male vs female; OR: 0.67; 95% CI: 0.55–0.82), younger age (OR: 2.98; 95% CI: 1.31–6.96 and OR: 1.56; 95% CI: 1.21–2.00), attending day care centers (OR: 2.97; 95% CI: 1.28–6.76), having infectious diseases (OR: 2.31; 95% CI: 1.10–4.52), using antibiotics (OR: 2.77; 95% CI: 1.45–5.05), residing in northern Taiwan (OR: 1.41; 95% CI: 1.15–1.71), passive smoking (OR: 1.30; 95% CI: 1.02–1.63), and pneumococcal vaccination (OR: 1.22; 95% CI: 1.01–1.48).ConclusionsChildren could act as reservoirs of MRSA transmissions. Hospitals remained the most frequent microorganism-circulated settings. More MRSA infection control strategies are required to prevent the dissemination among children.
Highlights
In the last decade, the overall burden of methicillin-resistant Staphylococcus aureus (MRSA) has considerably increased, both in communities and healthcare settings [1, 2]
Children recruited in the hospitals presented MRSA prevalence of 6.4%, which was higher than those recruited in the communities [2.7%]
A number of influencing factors for MRSA nasal colonization were noted in three eligible studies: gender, younger age (OR: 2.98; 95% confidence interval (CI): 1.31–6.96 and Odds Ratios (ORs): 1.56; 95% CI: 1.21–2.00), attending day care centers (OR: 2.97; 95% CI: 1.28–6.76), having infectious diseases (OR: 2.31; 95% CI: 1.10–4.52), using antibiotics (OR: 2.77; 95% CI: 1.45–5.05), residing in northern Taiwan (OR: 1.41; 95% CI: 1.15–1.71), passive smoking (OR: 1.30; 95% CI: 1.02–1.63), and pneumococcal vaccination (OR: 1.22; 95% CI: 1.01–1.48)
Summary
The overall burden of methicillin-resistant Staphylococcus aureus (MRSA) has considerably increased, both in communities and healthcare settings [1, 2]. It has caused serious health consequences since it was first identified in 1961 [3]. In the United States, the proportion of methicillin resistance in Staphylococcus aureus (S. aureus) strains approached almost 60% in 2003, with an average resistance rate of around 50% over the period 1998–2002 [7]. In Europe, the proportion of methicillin resistance in S. aureus strains, which are isolated from infected patients, varied from less than 0.5% to more than 50% in 2011, with a pooled average rate of around 17% [8]. The articles regard influencing factors of MRSA colonization are rare
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