Major article
The prevalence and influencing factors of methicillin-resistant Staphylococcus aureus carriage in people in contact with livestock: A systematic review

https://doi.org/10.1016/j.ajic.2014.12.009Get rights and content

Highlights

  • We found the prevalence of MRSA in people in contact with livestock (14.2%) was significantly higher than that of the general population (0.8-1.3%).

  • Animals contact and intensity of animals contact were associated with increased risk of MRSA carriage.

  • Our findings suggest that there may be transmission of MRSA between animals and humans.

Background

Methicillin-resistant Staphylococcus aureus (MRSA) is becoming a serious epidemic worldwide. Recently, studies have shown that people in contact with livestock may have a greater chance of MRSA carriage. We aimed to establish the prevalence of MRSA among people in contact with livestock and review the factors influencing MRSA carriage.

Methods

We systematically examined published epidemiologic studies on MRSA prevalence in people in contact with livestock using Pubmed, Medline, Embase, Ovid, and the Cochrane Library. Prevalence estimates were pooled using a random-effects model. Study heterogeneity was assessed using Q statistics and quantified with I2 statistics.

Results

Thirty-three eligible studies were included in this systematic review. Prevalence of MRSA ranged from 0.0%-85.8%. The pooled prevalence estimate of MRSA was 14.2% (95% confidence interval, 9.1%-20.1%) for people in contact with livestock. Substantial heterogeneity in eligible studies was noted (χ2 = 1,025; P < .001; I2 = 96.9%). Subgroup analysis showed the prevalence of MRSA was high in people from Europe (15.9%), farmers (18.2%), and by longitudinal study design (38.9%). Animal contact and intensity of animal contact were associated with increased risk of MRSA carriage.

Conclusion

Our findings suggest that there may be transmission of MRSA between animals and humans.

Section snippets

Literature search

Our systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.18 An online search of all published human epidemiologic studies (in English) on the prevalence of MRSA carriage in people in contact with livestock between January 1990 and May 2014 was conducted using the following databases: Pubmed, Medline, Embase, Ovid, and the Cochrane Library. Search terms included Staphylococcus aureus and livestock. Additionally, relevant

Eligible studies

The literature search and study selection process are shown in Figure 1. By reading abstracts and titles, 37 studies were selected for further investigation. After reviewing the full text of the remaining studies, 7 studies26, 27, 28, 29, 30, 31, 32 were excluded for the reasons noted in Figure 1. Three studies were included through manual searches of the relevant journals and reference lists.11, 33, 34 In total, 33 studies were ultimately included in our systematic review.7, 8, 9, 11, 12, 13,

Discussion

There is a lack of worldwide data regarding MRSA prevalence in people in contact with livestock. Ours is the first study systematically reviewing the prevalence of MRSA carriage in people in contact with livestock. Overall, we found a high prevalence of MRSA carriage in people in contact with livestock. Moreover, we found animal contact and intensity of animal contact were significantly related to MRSA carriage.

The prevalence of MRSA in people in contact with livestock (14.2%) was significantly

Conclusions

Our systematic review of observational studies suggests the prevalence of MRSA in people in contact with livestock is much higher than that of the general population. Moreover, animal contact and intensity of animal contact were associated with increased risk of MRSA carriage. Our findings suggest that there may be transmission of MRSA between animals and humans.

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  • Cited by (0)

    WL and SL contributed equally to this work.

    This work was supported by the Natural Science Foundation of Guangdong province (No. S2011010002481), the Innovation Fund of the Department of Education of Guangdong Province (No. 2013KJCX0112), and the Joint Natural Sciences Fund of the Department of Science and Technology and the First Affiliated Hospital of Guangdong Pharmaceutical University (No. GYFYLH201331). The funders had no role in study design, data collection and analysis, and interpretation of the data.

    Conflicts of interest: None to report.

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