Prevalence of methicillin-resistant Staphylococcus aureus in healthy Chinese population: A system review and meta-analysis

Abstract

ObjectiveTo comprehensively determine the prevalence of MRSA in healthy Chinese population, the influencing factors of MRSA colonization and its antibiotic resistance.MethodsArticles that studied prevalence or influencing factors of MRSA carriage in healthy Chinese population were retrieved from PubMed, Ovid database, three Chinese electronic databases. The pooled prevalence of MRSA, its antibiotic resistance and influencing factors were analyzed by STATA12.0.Results37 studies were included. The pooled prevalence of MRSA was 21.2% (95% CI: 18.5%-23.9%), and the prevalence of S.aureus was 15% (95% CI: 10%-19%), with a significant heterogeneity (MRSA: I2 = 97.6%, P<0.001; S.aureus: I2 = 98.4%, P < 0.001). In subgroup analysis, the pooled prevalence of MRSA was 28% (95%CI: 10%-51%) for Livestock-related workers, 18% (95%CI: 11%-26%) for children, 20% (95%CI: 12%-29%) for healthcare workers, 7% (95%CI: 3%-13%) for community residents. The prevalence of MRSA in studies with oxacillin disk diffusion method (28%, 95%CI: 21%-35%) seemed higher than that with the mecA gene method(12%, 95%CI: 7%-19%). MRSA in studies conducted in Taiwan was more common than in Mainland China and Hong Kong. Similar results were found in meta-regression. Influencing factors for MRSA colonization were noted in seven eligible studies, they included younger age (OR: 3.54, 95% CI: 2.38–5.26; OR: 2.24, 95% CI: 1.73–2.9), attending day care centers (DCCs) (OR: 1.95, 95% CI: 1.4–2.72; OR: 1.53, 95% CI: 1.2–1.95), flu vaccination (OR:1.73, 95% CI: 1.28–2.35), using antibiotics within the past year (OR: 2.05, 95% CI:1.35–3.11), residing in northern Taiwan (OR: 1.45, 95% CI: 1.19–1.77), regular visits to health care facility (OR: 23.83, 95% CI: 2.72–209.01), household member working in health care facility (OR: 8.98, 95% CI:1.4–55.63), and contact with livestock (OR: 6.31, 95% CI: 3.44–11.57). Moreover, MRSA was found to be highly resistant to penicillin, ampicillin, erythromycin, and clindamycin, with a pooled resistance ratio of 100, 93, 88, and 75%, respectively. However, no resistance were noted to vancomycin.ConclusionThe pooled prevalence of MRSA was considerably high in health Chinese population. Additionally, these strains showed extreme resistance to penicillin, ampicillin, erythromycin and clindamycin. Public MRSA protection measures and the surveillance of MRSA should be strengthened to reduce the spread of MRSA among hospitals, communities, and livestock.

A Systemic Literature Review and Meta-Analysis Reporting the Prevalence and Impact of Methicillin-ResistantStaphylococcus aureusInfection in India

“…54 A meta-analysis conducted by Wu and colleagues had reported an MRSA prevalence rate of 21.2% (95% CI, 18.5%-23.9%) in the healthy Chinese population. 2 Further, the reported prevalence of MRSA in Ethiopia, was 30.90% [95% CI, 21.81%-39.99%], while in Europe and the United States the prevalence rate was only 1.8% (95% CI, 1.34%-2.50%). 55,56 The subgroup analysis reported a higher prevalence of MRSA among males compared to females in the Indian population (60.4% vs 39.6%), thereby indicating male gender to be a risk factor for MRSA infections.…”

“…1 As early as 1942, penicillin-resistant Staphylococcus aureus strains were recognized, which further paved way to the development of semisynthetic penicillins, including methicillin. 2 Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most tenacious anti-microbial resistant pathogens reported in a range of infections, including the skin and wound infections, pneumonia, and bloodstream infections. 3,4 The emergence of MRSA through the acquisition of Staphylococcal cassette chromosome mec (SCCmec) was first identified in 1960.…”

“…3,4 The emergence of MRSA through the acquisition of Staphylococcal cassette chromosome mec (SCC mec ) was first identified in 1960. 2,5 The SCCmec carries the mecA gene that encodes the penicillin-binding protein (PBP2a), thereby acquiring resistance to all β-lactam antibiotics. 5 Newer drug-resistant homologues of the mecA gene have been reported in the recent years, including mecB, mecC , and/or mecD .…”

Antimicrobial activity of omadacycline in vitro against bacteria isolated from 2014 to 2017 in China, a multi-center study

“…Even against highly resistant bacterial strains such as methicillin-resistant S. aureus (MRSA), vancomycin-resistant enterococci (VRE), and PRSP, good antimicrobial activity has also been observed as per data obtained in the SENTRY antimicrobial surveillance program [ 10 ]. However, the prevalence and antimicrobial resistance rates of some bacterial species are different all over the world [ 11 ]. The aim of this study was to evaluate the in vitro activity of omadacycline against common bacteria in Mainland China.…”

All d-Lysine Analogues of the Antimicrobial Peptide HPA3NT3-A2 Increased Serum Stability and without Drug Resistance

“…Many antibiotics used to treat infectious diseases are ineffective against resistant Gram-negative and Gram-positive bacterial strains. Particularly, there has been an increase in the number of deaths associated with antibiotic-resistant bacterial infections such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and multiple drug-resistant organisms [1][2][3]. The mechanisms of drug resistance in these bacteria include genetic mutations, drug efflux, and enzymatic degradation of drugs.…”