Global epidemiology of asymptomatic colonisation of methicillin-resistant <i>Staphylococcus aureus</i> in the upper respiratory tract of young children: a systematic review and meta-analysis.

Abstract

To estimate the global prevalence of asymptomatic colonisation, and determine the associated risk factors, antibiotic resistance and genotypes of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) in the upper respiratory tract of young children. Four 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 of <i>S. aureus</i> and 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. We 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 with <i>S. aureus</i> and MRSA. The pooled prevalence of asymptomatic colonisation of <i>S. aureus</i> and MRSA of young children globally. In this systematic review and meta-analysis of 21 416 young children, the pooled global prevalence of asymptomatic <i>S. aureus</i> colonisation 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. This 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. CRD 42022328385.