Indian Journal of Pathology and Microbiology
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Year : 2014  |  Volume : 57  |  Issue : 3  |  Page : 418-422

Prevalence and invasiveness of community-acquired methicillin-resistant Staphylococcus aureus: A meta-analysis

Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China

Correspondence Address:
Xuzhuang Shen
No. 56, Nan-li-shi Road, Beijing - 100 045
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Source of Support: This study was supported by the National Natural Science Foundation of China (Grant No. 81171648), the National Natural Science Foundation of China, and the Research Grants Council of Hong Kong Joint Research Scheme (Grant No. 81061160509), Conflict of Interest: None

DOI: 10.4103/0377-4929.138737

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Background: Reports suggest that the prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased, and that CA-MRSA is more virulent than healthcare-associated (HA)-MRSA. Aims: The aim of this study is to gain a better understanding of the invasiveness and prevalence of CA-MRSA in patients; we systematically reviewed the literature by conducting a meta-analysis. Materials and Methods: We searched the MEDLINE and PUBMED databases from the year these databases were established to January 2013. Results: The pooled CA-MRSA prevalence among 50,737 patients from 33 studies was 39.0% (range, 30.8-47.8%). The pooled CA-MRSA prevalence rates among pediatric and adult patients with MRSA infection were 50.2% (range, 37.5-62.8%) and 42.3% (range, 16.4-73.3%), respectively. The pooled CA-MRSA prevalence rates of MRSA-infected patients in Asia, Europe, and North America were 23.1% (range, 12.0-39.8%), 37.4% (range, 21.1-56.4%), and 47.4% (range, 35.8-59.4%), respectively. Using the random effects model, we determined that the pooled odds ratio of invasive infections in CA- and HA-MRSA was 0.30 (95% confidence interval: 0.08-1.10; P = 0.07, test for heterogeneity P < 0.00001). Conclusions: The prevalence of CA-MRSA in MRSA infection varied with area and population. No difference in the ability to cause invasive infections was found between CA- and HA-MRSA. This finding challenges the view that CA-MRSA is more virulent than HA-MRSA.

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