Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysis
Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) colonization in neonatal intensive care units (NICUs) is a significant global health concern, leading to severe infections, extended hospital stays, and substantial economic burdens on health-care systems. To develop effective infectio...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Journal of Global Infectious Diseases |
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| Online Access: | https://journals.lww.com/10.4103/jgid.jgid_95_24 |
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| author | Seraphine Nkie Esemu Arnol Bowo-Ngandji Roland Ndip Ndip Jane-Francis Tatah Kihla Akoachere Nene Kaah Keneh Jean Thierry Ebogo-Belobo Cyprien Kengne-Ndé Donatien Serge Mbaga Nicholas Tendongfor Hortense Kamga Gonsu Jean Paul Assam Assam Lucy Mande Ndip |
| author_facet | Seraphine Nkie Esemu Arnol Bowo-Ngandji Roland Ndip Ndip Jane-Francis Tatah Kihla Akoachere Nene Kaah Keneh Jean Thierry Ebogo-Belobo Cyprien Kengne-Ndé Donatien Serge Mbaga Nicholas Tendongfor Hortense Kamga Gonsu Jean Paul Assam Assam Lucy Mande Ndip |
| author_sort | Seraphine Nkie Esemu |
| collection | DOAJ |
| description | Introduction:
Methicillin-resistant Staphylococcus aureus (MRSA) colonization in neonatal intensive care units (NICUs) is a significant global health concern, leading to severe infections, extended hospital stays, and substantial economic burdens on health-care systems. To develop effective infection control strategies, we need to fill existing gaps in our understanding of MRSA epidemiology in neonates. The aim of this systematic review is to provide an extensive analysis of the proportion of MRSA colonizations in NICUs.
Methods:
We used a comprehensive search strategy across databases such as Medline, Embase, Global Health, Web of Science, and Global Index Medicus, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were independently reviewed and selected based on a variety of criteria, including the inclusion of neonates tested for MRSA colonization during NICU stay, and the reporting of community-acquired and hospital-acquired MRSA (CA-MRSA and HA-MRSA) incidence levels. Exclusion criteria included studies outside NICUs, those focused on specific MRSA outbreaks or clinical infections, review studies, and those lacking abstracts or full texts. Five authors independently extracted data, which was summarized and checked for quality. Statistical analysis included a random-effects model to compute pooled proportions, stratification by geographical location, evaluation of heterogeneity, and examination of publication bias.
Results:
Our systematic review evaluated 62 studies out of an initial 536 records identified. The majority of the selected studies were conducted in high-income countries, primarily in the United States. From these studies, we estimated a cumulative incidence rate of 7.2% for MRSA colonization in NICUs. When the source of MRSA was considered, CA-MRSA incidence was 2.7%, while HA-MRSA incidence was notably higher at 11%. A subgroup analysis showed geographical differences in the cumulative incidence of MRSA colonization in NICUs, with Brazil having the lowest incidence and Taiwan the highest. The proportion of HA-MRSA colonization also varied significantly by country, with South Korea reporting higher incidence rates than the United States. However, the differences in CA-MRSA colonization rates between countries and WHO regions were not statistically significant.
Conclusions:
Our systematic review found a cumulative incidence of 7.2% for MRSA colonization in NICUs, with HA-MRSA (11%) being more prevalent than CA-MRSA (2.7%). Regional variations were detected, with Taiwan exhibiting the highest cumulative incidence and South Korea having both the highest CA-MRSA and HA-MRSA. These findings underline the substantial public health impact of MRSA, especially in NICUs, necessitating context-specific prevention and control strategies. Future research should strive to address these regional disparities and aspire to attain a more globally representative understanding of MRSA colonization rates. |
| format | Article |
| id | doaj-art-17f5b66cd8a5488a80df939f0072c55c |
| institution | Kabale University |
| issn | 0974-777X 0974-8245 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Global Infectious Diseases |
| spelling | doaj-art-17f5b66cd8a5488a80df939f0072c55c2025-01-07T07:10:17ZengWolters Kluwer Medknow PublicationsJournal of Global Infectious Diseases0974-777X0974-82452024-12-0116416018210.4103/jgid.jgid_95_24Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysisSeraphine Nkie EsemuArnol Bowo-NgandjiRoland Ndip NdipJane-Francis Tatah Kihla AkoachereNene Kaah KenehJean Thierry Ebogo-BeloboCyprien Kengne-NdéDonatien Serge MbagaNicholas TendongforHortense Kamga GonsuJean Paul Assam AssamLucy Mande NdipIntroduction: Methicillin-resistant Staphylococcus aureus (MRSA) colonization in neonatal intensive care units (NICUs) is a significant global health concern, leading to severe infections, extended hospital stays, and substantial economic burdens on health-care systems. To develop effective infection control strategies, we need to fill existing gaps in our understanding of MRSA epidemiology in neonates. The aim of this systematic review is to provide an extensive analysis of the proportion of MRSA colonizations in NICUs. Methods: We used a comprehensive search strategy across databases such as Medline, Embase, Global Health, Web of Science, and Global Index Medicus, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were independently reviewed and selected based on a variety of criteria, including the inclusion of neonates tested for MRSA colonization during NICU stay, and the reporting of community-acquired and hospital-acquired MRSA (CA-MRSA and HA-MRSA) incidence levels. Exclusion criteria included studies outside NICUs, those focused on specific MRSA outbreaks or clinical infections, review studies, and those lacking abstracts or full texts. Five authors independently extracted data, which was summarized and checked for quality. Statistical analysis included a random-effects model to compute pooled proportions, stratification by geographical location, evaluation of heterogeneity, and examination of publication bias. Results: Our systematic review evaluated 62 studies out of an initial 536 records identified. The majority of the selected studies were conducted in high-income countries, primarily in the United States. From these studies, we estimated a cumulative incidence rate of 7.2% for MRSA colonization in NICUs. When the source of MRSA was considered, CA-MRSA incidence was 2.7%, while HA-MRSA incidence was notably higher at 11%. A subgroup analysis showed geographical differences in the cumulative incidence of MRSA colonization in NICUs, with Brazil having the lowest incidence and Taiwan the highest. The proportion of HA-MRSA colonization also varied significantly by country, with South Korea reporting higher incidence rates than the United States. However, the differences in CA-MRSA colonization rates between countries and WHO regions were not statistically significant. Conclusions: Our systematic review found a cumulative incidence of 7.2% for MRSA colonization in NICUs, with HA-MRSA (11%) being more prevalent than CA-MRSA (2.7%). Regional variations were detected, with Taiwan exhibiting the highest cumulative incidence and South Korea having both the highest CA-MRSA and HA-MRSA. These findings underline the substantial public health impact of MRSA, especially in NICUs, necessitating context-specific prevention and control strategies. Future research should strive to address these regional disparities and aspire to attain a more globally representative understanding of MRSA colonization rates.https://journals.lww.com/10.4103/jgid.jgid_95_24colonizationepidemiologymethicillin-resistant staphylococcus aureusneonatesneonatal intensive care units |
| spellingShingle | Seraphine Nkie Esemu Arnol Bowo-Ngandji Roland Ndip Ndip Jane-Francis Tatah Kihla Akoachere Nene Kaah Keneh Jean Thierry Ebogo-Belobo Cyprien Kengne-Ndé Donatien Serge Mbaga Nicholas Tendongfor Hortense Kamga Gonsu Jean Paul Assam Assam Lucy Mande Ndip Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysis Journal of Global Infectious Diseases colonization epidemiology methicillin-resistant staphylococcus aureus neonates neonatal intensive care units |
| title | Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysis |
| title_full | Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysis |
| title_fullStr | Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysis |
| title_full_unstemmed | Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysis |
| title_short | Epidemiology of Methicillin-resistant Staphylococcus aureus Colonization in Neonates within Neonatal Intensive Care Units: A Systematic Review and Meta-analysis |
| title_sort | epidemiology of methicillin resistant staphylococcus aureus colonization in neonates within neonatal intensive care units a systematic review and meta analysis |
| topic | colonization epidemiology methicillin-resistant staphylococcus aureus neonates neonatal intensive care units |
| url | https://journals.lww.com/10.4103/jgid.jgid_95_24 |
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