Top

Journal of Public Health

Published in:

11-10-2022 | Review Article

The prevalence of methicillin-resistant Staphylococcus aureus in the noses of Iranian medical staff: a systematic review and meta-analysis

Authors: Hakimeh Akbari, Masoud Mohammadi

Published in: Journal of Public Health | Issue 11/2023

Abstract

Objective

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important pathogens in hospitals. Studies on this subject have looked for very scattered and different results, which are highly heterogeneous. The search shows that the prevalence in Shahr-e-kord is 44.2%, 70% in Babol, and 5.4% in Yasuj, Accordingly, this study intends to determine the overall prevalence of methicillin-resistant Staphylococcus aureus in the noses of Iranian medical staff via meta-analysis.

Materials and methods

The research protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42018099360). The articles related to the considered subject were reviewed by searching the databases, including Web of Sciences (WoS), ProQuest, Embase, Medline (PubMed) and ScienceDirect, Scopus, Google Scholar, the Persian-language journal database Magiran, and the Iranian Scientific Information Database (SID) from January 2001 to January 2021. Duplicate publications were removed using the software EndNote, and the STROBE checklist was used for the quality appraisal of studies. Data analysis was performed in Comprehensive Meta-Analysis (CMA) software.

Results

The prevalence of MRSA in the noses of Iranian medical staff was 31.7% (95% CI: 22.3%–42.9%). Based on meta-regression, with an increase in the sample size, the prevalence of Staphylococcus aureus resistance to methicillin decreases and, over time in the years researched, the prevalence of MRSA in Iranian medical centre staff also increased (P < 0.05).

Conclusion

Based on the results of the study and based on meta-analysis and meta-regression analysis, the prevalence of MRSA in the noses of Iranian medical staff has become significantly higher; over the period of research, this prevalence shows a growing trend, and therefore it is necessary to persuade health authorities in Iran to take this issue seriously.

Aires de Sousa M, Crisostomo MI, Sanches IS, Wu JS, Fuzhong J, Tomasz A, Delencastre H (2003) Frequency recovery of a single clonal type of multidrug-resistant Staphylococcus aureus from patients in two hospitals in Taiwan and China. J Clin Microbiol 41(1):159–163PubMedPubMedCentralCrossRef

Akbar N, Seher S, Dodhy M, Hayat A (2002) Nasal carriage of Staphylococcus aureus in health care workers in Rawalpindi General Hospital. J Rawal Med Coil 6:74–76

Alavi SM, Rajabzadeh AR, Dezfolian A, Haghighizadeh MH (2006) Identification of Staphylococcus aureus carriers and antibiotic resistance in Razi Hospital staff in Ahvaz City in the first quarter in 2003. Jundishapur Scientific Med J 5(1):381–389

Alghaithy AA, Bilal NE, Gedebou M et al (2000) Nasal carriage and antibiotic resistance of Staphylococcus aureus isolates from the hospital and non-hospital personnel in Abha, Saudi Arabia. Trans R Soc Trop Med Hyg 94(5):504–507PubMedCrossRef

Askarian M, Zeinalzadeh A, Japoni A, Alborzi A (2009) Risk factors of nasal carriage of methicillin-resistant Staphylococcus Aureus and its Antibiotic susceptibility pattern in Namazi Hospital healthcare workers in Shiraz, Iran. J Kerman Univ Med Sci 15(1):65–77

Blok H, Troelstra A, Kamp-Hopmans T et al (2003) Role of health care workers in outbreaks of methicillin-resistant Staphylococcus aureus: a 10-year evaluation from a Dutch university hospital. Infect Control Hosp Epidemiol 24(9):679–685PubMedCrossRef

Cespedes C, Miller M, Quagliarello B, Vavagiakis P, Klein RS, Lowy F D (2002) Differences between Staphylococcus aureus Isolates from medical and nonmedical hospital personnel. J Clin Microbiol 40:2594–2597

Cesur S, Cokca F (2004) Nasal carriage of methicillin-resistant Staphylococcus aureus among hospital staff and outpatients. Infect Control Hosp Epidemiol 25(2):169–170PubMedCrossRef

Citak S, Bayazit FN, Aksoy F (2011) Nasal carriage and methicillin-resistant Staphylococcus aureus in patients and hospital staff in a tertiary referral center setting. Afr J Microbiol Res 5(13):1615–1618CrossRef

Dadashi A, Firoozi F, Sanjarbeigi N, Zahedi Nasab A, Amiri H, Nikooei M (2015) Prevalence and susceptibilities of coagulase negative Staphylococci isolated in health care workers in a military hospital, Kermanshah. Nurse and Physician Within War 3(7):11–17

De Carvalho MJ, Pimenta F, Hayashida M et al (2009) Prevalence of methicillin-resistant and methicillin-susceptible S. aureus in the saliva of health professionals. Clinics (Sao Paulo) 64(4):295–302PubMedCrossRef

Ebadi M, Khaliliazad T (2018) Staphylococcal cassette chromosome (SCCmec) typing of methicillin-resistant Staphylococcus aureus strains isolated from healthy workers nasal swabs in Larestan hospitals. J Microb World 11(1):40–50

Farzana K, Rashid Z, Akhtar N et al (2008) Nasal carriage of staphylococci in health care workers: antimicrobial susceptibility profile. Pak J Pharm Sci 21(3):290–294PubMed

Firouzi F, Akhtari J, Nasrolahei M (2016) Prevalence of MRSA and VRSA strains of Staphylococcus aureus in healthcare staff and inpatients. J Mazandaran Univ Med Sci 26(142):96–107

Ghafouri M, Besharati R, Lashkardoost H, Nojoomi S, Shakeri A, Shahsavand S (2014) Prevalence of nasal carrier Staphylococcus aureus and their antibiotic resistance patterns among health care working in Bojnurd Imam Reza Hospital. J North Khorasan Univ Med Sci 6(1):111–116CrossRef

Habibi M, Iravani BM (2007) Prevalence of methicillin and vancomycin-resistant Staphylococcus aureus colonization in nasopharynx Amir-Alam hospital, 2005. Tehran Univ Med J 65(3):78–81

Hosain Zadegan H, Menati S, Tarrahi M, Mohammadi F (2008) Screening of methicillin and vancomycin-resistant Staphylococcus aureus in the nasal of hospital personnel of Khorram Abad, Iran. mljgoums 2(1):26–32

Jalalpoor S (2010) The spread of beta-lactam antibiotic-resistant Staphylococcus aureus and Staphylococcus epidermidis strains in hospital. mljgoums 4(2):60–66

Jomehpour N, Rezaei Manesh MR (2016) Investigation of the frequency of Staphylococcus aureus carriers and its methicillin-resistant pattern in Torbat Heydariyeh hospitals staff in 2013. J Tanin Salamat (Health Chimes) 4(1):42–49

Kakinohana S, Uemura E, Insisiengmay S, Higa N, Wanaga M (2002) Staphylococcus aureus isolated from hospital staff: a comparative study of Laos and Japan. J Infect Chemother 8(4):336–340PubMedCrossRef

Kalhor H, Validi M, Nafisi M (2013) Evaluation of the frequency of methicillin-resistant Staphylococcus isolated from nose of nursing personnel of Hajar Hospital of Shahrekord. Qom Univ Med Sci J 7(1):42–49

Kampf G, Kramer A (2004) Epidemiologic background of hand hygiene and evaluation of the most important agents for scrubs and rubs. Clin Microbiol Rev 17(4):863–893PubMedPubMedCentralCrossRef

Karmostaji A, Moradi N, Boushehri E, Jahed M, Dadsetan B, Sanginabadi F et al (2008) Nasal carrier rates and antibiogram pattern of Staphylococcus aureus strains isolated from hospital staff in teaching hospitals in Bandar Abbas. HMJ 12(2):95–101

Khaleghi M, Zareei H, Bokaeian M, Saeidi S (2015) Evaluation of Staphylococcus aureus resistance to methicillin in Zabol hospital in 2010. J Appl Biol Alzahra Univ 28(1):51–58

Khalili MB, Moshref M, Sharifi M, Sadeh M, Sazmand A (2013) Prevalence of Staphylococcus aureus (SA) and methicillin-resistant Staphylococcus aureus (MRSA) in personnel of operation room of Shahid Sadoughi Hospital, Yazd, Iran. J Payavard Salamat 6(5):392–402

Kim HB, Park WB, Lee KD, Choi YJ, Park SW, Oh MD, Kim EC, Choe KW (2003) Nationwide surveillance for Staphylococcus aureus with reduced susceptibility to vancomycin in Korea. J Clin Microbiol 41(6):2279–2281PubMedPubMedCentralCrossRef

Lee HJ, Suh JT, Kim YC, Lenz W, Bierbaum G, Schaal KP (2001) Typing and antimicrobial susceptibilities of methicillin-resistant Staphylococcus aureus (MRSA) strains in a hospital in Korea. J Korean Med Sci 16:381–385PubMedPubMedCentralCrossRef

Lister JL, Horswill AR (2014) Staphylococcus aureus biofilms: recent developments in biofilm dispersal. Front Cell Infect Microbiol 23(4):178

Lowy FD (2003) Antimicrobial resistance: the example of Staphylococcus aureus. J Clin Invest 111(9):1265–1273PubMedPubMedCentralCrossRef

Lowy FD (2005) Staphylococcal infections. In: Kasper DL, Fauci AS, Hauser SL, Lango DL, Jameson JL (eds) Harrison's principles of internal medicine, 16th edn. McGraw-Hill, USA, pp 814–823

Mahmoudi Mourderaz Y, Chaman R, Malekhosseini A, Sharifi A, Khosravani S, Taher Rezanejad M et al (2017) Antimicrobial resistance pattern and agr typing among Staphylococcus aureus isolated from nasal carrier personnel in Shahid Beheshti Hospital in Yasuj City. J Adv Med Biomed Res 25(113):91–102

MansouriGhiasi M, NasrollahiOmran A, Hashemi M, Rajab ZadeKanafi P, Jahangiri Rad Manjili M (2013) The prevalence of antibiotic resistance pattern of Staphylococcus aureus isolated from nasal carriage of surgical ward’s staff in Shahidrajaee Hospital of Tonekabon, Iran. MLJ 7(1):35–39

Mdani TA, Al-Abdollah NA, Al-Sanousi A (2001) Methicillin–resistant Staphylococcus aureus in two tertiary-care centres in Jeddah, Saudi Arabia. Infect Control Hosp Epidemiol 22:211–216CrossRef

Nikooei M, Firoozi F, Sanjarbaigi N, Zahedinasab A, Amiri H, Dadashi A (2015) Determination of prevalence of Staphylococcus aureus nasal carriages and antibiotic resistance pattern in health care workers of 520 Kermanshah Hospital, winter 92. Hakim Health Sys Res 18(1):42–48

Nourbakhsh F, Nourbakhsh V, Borooni S, Tajbakhsh E, Daneshmand D (2020) Molecular investigation of Staphylococcal cassette chromosome mec (SCCmec) elements isolated from intensive care unit. IJML 7(2):138–144

Oteo J, Baquero F, Vindel A, Campos J (2004) Antibiotic resistance in 3113 blood isolate of Staphylococcus aureus in 40 Spanish hospitals participating in the European Antimicrobial Resistance Surveillance System. J Antimicrob Chemother 53:1033–1038PubMedCrossRef

Rahbar M, Karami Yar M, Ghareh Aghaji R, Vakili H, Khalil Rajaei Y (2001) The Study of the Frequency of Methicillin-resistant Staphylococcus aureus among the Personnel of Imam Khomeini Educational and Clinical Center. The 4th Conference on Microbiology with Bacteriology Tendency. Medical College-Shahed University 2001/07/11 to 2001/09/11. Tehran Shahed University, Tehran, pp. 171-172

Rahimi-Alang S, Asmar M, Cheraghali F, Yazarlou S, Amini A, Shakeri F, Ghaemi EA (2010) Frequency of methicillin-resistant Staphylococcus aureus in health care workers in Gorgan. Zahedan J Res Med Sci (ZJRMS) 13(1):17–22

Rezende NA, Blumberg HM, Metzger BS, Larsen NM, Ray SM, McGowan JE Jr (2002) Risk factors for methicillin-resistance among patients with Staphylococcus aureus bacteremia at the time of hospital admission. Am J Med Sci 323(3):117–123PubMedCrossRef

Saadat S, Solhjoo K, Norouz-nejadfard MJ, Kazemi A, Rouhi R, Mardaneh J (2014a) The frequency of Staphylococcus aureus among Shiraz Hospital personnel and determination of their antibiotic sensitivity pattern. ISMJ 17(5):916–926

Saadat S, Solhjoo K, Kazemi A, Mradaneh J (2014b) Antibiotic resistance pattern of Staphylococcus aureus strains isolated from personnel of Jahrom Hospitals in 2012. Armaghan-Danesh, Yasuj University of Medical Sciences Journal (YUMSJ) 18(10):826–835

Sabbagh P, Ebrahimzadeh-Namvar A, Ferdosi-Shahandashti E, Javanian M, Khafri S, Rajabnia M (2017) Molecular characterization of Staphylococcus aureus strains isolated among hospital staff nasal carriers of Babol, Iran. Caspian J Intern Med 8(4):311–316PubMedPubMedCentral

Saderi H, Ôwlia P, Zafarghandi N, Jalalinadoshan M (2004) Evaluation of antibiotic resistance in staphylococcus aureus isolated from nose of two teaching hospitals staff of Shahed University. J Mazandaran Univ Med Sci 14(42):69–75

Shibabaw A, Abebe T, Mihret A (2013) Nasal carriage rate of methicillin-resistant Staphylococcus aureus among Dessie Referral Hospital health care workers; Dessie, Northeast Ethiopia. Antimicrob Resist Infect Control 2(1):25PubMedPubMedCentralCrossRef

Shopsin B, Kreiswirth BN (2001) Molecular epidemiology of methicillin-resistant Staphylococcus aureus. Emerg Infect Dis 7:323–326PubMedPubMedCentralCrossRef

Silva EC, Antas MG, Monteiro B, Neto A et al (2008) Prevalence and risk factors for Staphylococcus aureus in health care workers at a university hospital of Recife-PE. Braz J Infect Dis 12(6):504-508

Silvana M, Emmanuel R, Carlos C (2005) Prevalence of Staphylococcus aureus introduced into intensive care units of a university hospital. Braz J Infect Dis Salvador 9(1):1–12

Sola C, Gribaudo G, Vindel A, Patrito L, Bocco JL (2002) Identification of a novel methicillin-resistant Staphylococcus aureus epidemic clone in Cordoba, Argentina, involved in nosocomial infections. J Clin Microbiol 40:1427–1435PubMedPubMedCentralCrossRef

Suggs AH, Maranan MC, Boyle VS, Daum RS (1999) Methicillin-resistant and borderline methicillin-resistant asymptomatic Staphylococcus aureus colonization in children without identifiable risk factors. Pediatr Infect Dis 18:410–414CrossRef

Tafaroji J, Aghaali M, Heydari H (2017) An investigation of the frequency of Staphylococcus aureus nasal carriers and its antibiotic susceptibility pattern in the staff of different wards of Qom Hazrat Masumeh Hospital, 2015, Iran. Qom Univ Med Sci J 10(11):79–84

Tambic A, Power EGM, Tambic T, Snur I, French GL (1999) Epidemiological analysis of methicillin-resistant Staphylococcus aureus in a Zagreb Trauma Hospital using a randomly amplified polymorphic DNA-typing method. Eur J Microbial Infect Dis 18:335–340CrossRef

Tenover FC, Biddle IW, Lancaster MY (2001) Increasing resistance to vancomycin and other glycopeptides in Staphylococcus aureus. Emerg Infect Dis 7(2):327–332PubMedPubMedCentralCrossRef

Tiemersma EW, Bronzwaer SLAM, Lyytikainen 0, Degener JE, Schrijnemakers P, Bruinsma N et al (2004) Methicillin-resistant Staphylococcus aureus in Europe, 1999-2002. Emerg Infect Dis 10:1627–1634

Treakle AM, Thom KA, Furuno JP et al (2009) Bacterial contamination of health care workers’ white coats. Am J Infect Control 37(2):101–105PubMedCrossRef

Udo EE, Al-Sweih R, Dahr TS, Dimitrov EM, Mokaddas M, Johny IA et al (2008) surveillance of antibacterial resistance in Staphylococcus aureus isolated in Kuwaiti hospitals. Med Prink Pract 17:71–75CrossRef

Vinodhkumaradithya A, Uma A, Shirivasan M, Ananthalakshmi I, Nallasivam P, Thirumalaikolundusubramanian P (2009) Nasal carriage of methicillin-resistant Staphylococcus aureus among surgical unit staff. Jpn J Infect Dis 62(3):228–229CrossRef

Wang JT, Chen YC, Yang TL, Chang SC (2002) Molecular epidemiology and antimicrobial susceptibility of multidrug-resistant Staphylococcus aureus in Taiwan. Diagn Microbiol Infect Dis 42(3):199–203PubMedCrossRef

Title: The prevalence of methicillin-resistant Staphylococcus aureus in the noses of Iranian medical staff: a systematic review and meta-analysis
Authors: Hakimeh Akbari
Masoud Mohammadi
Publication date: 11-10-2022
Publisher: Springer Berlin Heidelberg
Published in: Journal of Public Health / Issue 11/2023
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-022-01759-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The prevalence of methicillin-resistant Staphylococcus aureus in the noses of Iranian medical staff: a systematic review and meta-analysis

Abstract

Objective

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 11/2023

Psychosocial and environmental determinants of active transport to school in Austrian rural communities: a cross-sectional study among schoolchildren and their parents

Application of the capture–recapture method to ascertain the completeness of the Saxon pediatric IBD registry in Germany

Get up, stand up: a randomized controlled trial to assess the effectiveness of a messenger-based intervention to reduce sedentary behavior in university students

Socio-economic, demographic, and familial correlates of physical activity and dietary practices among adolescent boys in Bihar, India

Active commuting associations with BMI and self-rated health: a cross-sectional analysis of the Healthy Ireland survey

Global COVID-19 vaccine acceptance rate: a systematic review and meta-analysis