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一项关于医护人员经常接触的环境物体表面金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌污染率的荟萃分析。

A meta-analysis of the rates of Staphylococcus aureus and methicillin-resistant S aureus contamination on the surfaces of environmental objects that health care workers frequently touch.

作者信息

Lin Dongxin, Ou Qianting, Lin Jialing, Peng Yang, Yao Zhenjiang

机构信息

Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China.

Centre for Chronic Diseases, University of Queensland, Brisbane, QLD, Australia.

出版信息

Am J Infect Control. 2017 Apr 1;45(4):421-429. doi: 10.1016/j.ajic.2016.11.004. Epub 2016 Dec 20.

Abstract

BACKGROUND

Health care workers may potentially spread Staphylococcus aureus and methicillin-resistant S aureus (MRSA) to patients by contaminated high-touch items. We aimed to determine the pooled rates of S aureus and MRSA contamination and influencing factors.

METHODS

A literature search of the PubMed, ScienceDirect, Embase, Ovid, and Scopus databases was performed. Pooled contamination rates were determined using random effect models. Subgroup and meta-regression analyses were conducted to identify factors potentially influencing the rates of S aureus and MRSA contamination. Sensitivity and publication bias analyses were performed.

RESULTS

Thirty-eight studies were included in the meta-analysis. The pooled contamination rates were 15.0% (95% confidence interval [CI], 9.8%-21.1%) for S aureus and 5.0% (95% CI, 2.7%-7.7%) for MRSA. The subgroup analyses indicated that the pooled rate of S aureus contamination was significantly higher for studies conducted in South America, in developing countries, and during 2010-2015. The pooled rate of MRSA contamination was significantly higher for studies conducted in Africa. The meta-regression analysis suggested that the pooled rate of S aureus contamination was lower for studies conducted in developed countries (odds ratio, 0.664; 95% CI, 0.509-0.867; P = .004). No bias was found in the publication of the rates of S aureus and MRSA contamination.

CONCLUSIONS

S aureus and MRSA contamination statuses of high-touch items are worrisome and should be paid greater attention. Developing country status was a risk factor for S aureus contamination.

摘要

背景

医护人员可能通过被污染的高频接触物品将金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌(MRSA)传播给患者。我们旨在确定金黄色葡萄球菌和MRSA污染的合并率及影响因素。

方法

对PubMed、ScienceDirect、Embase、Ovid和Scopus数据库进行文献检索。使用随机效应模型确定合并污染率。进行亚组分析和Meta回归分析以识别可能影响金黄色葡萄球菌和MRSA污染率的因素。进行敏感性分析和发表偏倚分析。

结果

38项研究纳入Meta分析。金黄色葡萄球菌的合并污染率为15.0%(95%置信区间[CI],9.8%-21.1%),MRSA为5.0%(95%CI,2.7%-7.7%)。亚组分析表明,在南美洲、发展中国家以及2010-2015年期间进行的研究中,金黄色葡萄球菌的合并污染率显著更高。在非洲进行的研究中,MRSA的合并污染率显著更高。Meta回归分析表明,在发达国家进行的研究中,金黄色葡萄球菌的合并污染率较低(比值比,0.664;95%CI,0.509-0.867;P = 0.004)。未发现金黄色葡萄球菌和MRSA污染率发表存在偏倚。

结论

高频接触物品的金黄色葡萄球菌和MRSA污染状况令人担忧,应给予更多关注。发展中国家状况是金黄色葡萄球菌污染的一个危险因素。

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