Community‐Acquired Methicillin‐ResistantStaphylococcus aureus:A Meta‐Analysis of Prevalence and Risk Factors

Abstract

Reports suggest that carriage of methicillin-resistant Staphylococcus aureus (MRSA) among persons without health care-associated risks has increased. A meta-analysis of studies reporting the prevalence of community-acquired MRSA (CA-MRSA) among MRSA isolates from hospitalized patients or the prevalence of MRSA colonization among community members was conducted. The CA-MRSA prevalence among hospital MRSA was 30.2% in 27 retrospective studies and 37.3% in 5 prospective studies; 85% of all patients with CA-MRSA had > or =1 health care-associated risk. The pooled MRSA colonization rate among community members was 1.3% (95% confidence interval [CI], 1.04%-1.53%), but there was significant heterogeneity among study populations. Community members from whom samples were obtained in health care facilities were more likely to be carrying MRSA than were community members from whom samples were obtained outside of the health care setting (relative risk, 2.35; 95% CI, 1.56-3.53). Among studies that excluded persons with health care contacts, the MRSA prevalence was 0.2%. Moreover, most persons with CA-MRSA had > or =1 health care-associated risk, which suggests that the prevalence of MRSA among persons without risks remains low (< or =0.24%). Effective control of dissemination of MRSA throughout the community likely will require effective control of nosocomial MRSA transmission.

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

“…Control of dissemination of MRSA throughout the community requires effective control of nosocomial MRSA transmission [20] and, therefore, the surveillance/control strategy adopted, whilst not neglecting community effects, should concentrate on reducing hospital transmission. We believe this implies that on-admission screening alone cannot be used to control MRSA epidemics or any other infection which is driven by transmission between inpatients.…”

Characterization of a strain of community-associated methicillin-resistant Staphylococcus aureus widely disseminated in the United States

“…Recently, strains of methicillin (oxacillin)-resistant S. aureus (MRSA) have been recovered from infections in community settings (8,11,27,44,49,64) and among the urban poor in San Francisco, California (12). Most community MRSA strains harbored the lukF-PV and lukS-PV determinants, which encode the PantonValentine leucocidin (PVL) toxin (20,26,28,35,43).…”

Colonización por Staphylococcus aureus resistente a la meticilina en una unidad de cuidados intensivos de adultos de un hospital colombiano: caracterización fenotípica y molecular con detección de un clon de circulación en la comunidad

“…Sin embargo, no existen puntos de corte o criterios universales para determinar adecuadamente el origen de estos aislamientos (como SARM-AH o SARM-AC), lo cual genera dificultades para su correcta clasificación. Existe diversidad de criterios al respecto, como lo confirma un metanálisis en el que se encontró gran variedad de criterios temporales para hacer la clasificación (35).…”