Global epidemiology of asymptomatic colonisation of methicillin-resistantStaphylococcus aureusin the upper respiratory tract of young children: a systematic review and meta-analysis

Abstract

ObjectiveTo estimate the global prevalence of asymptomatic colonisation, and determine the associated risk factors, antibiotic resistance and genotypes of methicillin-resistantStaphylococcus aureus(MRSA) in the upper respiratory tract of young children.DesignFour bibliometric databases were searched for publications between 2010 and 2022 according to the protocol registered in PROSPERO. Cross-sectional or cohort studies describing the prevalence of asymptomatic colonisation ofS. aureusand MRSA in young children were included. Data extraction and analysis were carried out by two reviewers independently according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Pooled prevalence was estimated using a random effects model.Setting and studiesWe included studies where children without respiratory tract infection or Staphylococcal infection were recruited from the community, children’s institutions (ie, nurseries, kindergartens, daycare centres and preschools) and healthcare centre visits and assessed for asymptomatic colonisation withS. aureusand MRSA.Main outcome measuresThe pooled prevalence of asymptomatic colonisation ofS. aureusand MRSA of young children globally.ResultsIn this systematic review and meta-analysis of 21 416 young children, the pooled global prevalence of asymptomaticS. aureuscolonisation was 25.1% (95% CI 21.4 to 28.8) and MRSA colonisation was 3.4% (95% CI 2.8 to 4.1). The clones of MRSA strains included healthcare-associated MRSA, community-associated MRSA and livestock-associated MRSA.ConclusionThis study provides evidence of increased MRSA colonisation globally among young children, underlining the critical role of asymptomatic carriers in MRSA transmission and the need for control measures.PROSPERO registration numberCRD 42022328385.