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Prevalence and risk factors of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) carriage in Asia-Pacific region from 2000 to 2016: A systematic review and meta-analysis

Research output: Contribution to Journal/MagazineMeeting abstractpeer-review

<mark>Journal publication date</mark>08/2018
<mark>Journal</mark>International Journal of Infectious Diseases
Issue numberSuppl.
Number of pages2
Pages (from-to)135-136
Publication StatusPublished
Early online date27/07/18
<mark>Original language</mark>English


Objective: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging global public health threat. In response to a highlighted strategic priority of the World Health Organization Global Action Plan on Antimicrobial Resistance, to “strengthen the knowledge and evidence base through surveillance and research”, we synthesized published articles to estimate CA-MRSA carriage prevalence in the Asia-Pacific region.

Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD: 42017067399). We searched MEDLINE, EMBASE, and PubMed for articles published from January 1, 2000, to May 19, 2017, that reported CA-MRSA carriage, defined as either colonization or infection, in Asia-Pacific region, from 2000 to 2016. Studies were stratified according to (1) setting (community or hospital where CA-MRSA was isolated) and (2) study population (general public or subpopulations categorized according to specified characteristics). Prevalence of CA-MRSA carriage was estimated using a DerSimonian-Laird random-effects model.

Results: A total of 153 studies were identified. In community level studies, the CA-MRSA prevalence among the general public ranged from 0.3% - 23.5% (pooled prevalence:5.0%; 95%CI 2.2, 8.8). The prevalence among the same group in hospital settings ranged from 0% - 10.4% (pooled prevalence: 2.1% 95% CI 0.9, 3.7). The country with the highest community setting prevalence was India, followed by Vietnam and Taiwan. Children 6 years and household members of CA-MRSA carriers had the highest carriage in community settings.

Conclusion: The current CA-MRSA prevalence estimates provide a baseline for future national and international surveillance. The pooled prevalence and identification of characteristics associated with CA-MRSA carriage in the community can inform health authorities to formulate specific infection control policies on high-risk subgroups. Future studies should explore the heterogeneities in the prevalence of CA-MRSA carriage among subgroups and countries, in order to clarify the predominant transmission mechanisms in Asia-Pacific and other regions.