Ghia Canna Jagdish, Waghela Shaumil, Rambhad Gautam
Medical and Scientific Affairs, Pfizer Limited, Mumbai, India.
Infect Dis (Auckl). 2020 Nov 5;13:1178633720970569. doi: 10.1177/1178633720970569. eCollection 2020.
This systematic review and meta-analysis was conducted to assess the prevalence, burden and epidemiology of methicillin-resistant (MRSA). This systemic review was also aimed to highlight the challenges in the diagnosis and management of methicillin-resistant (MRSA) in India (for all age groups). We also examined the published literature on the available treatment options and the role of prevention in the management of MRSA in India. By summarizing the currently available data, our objectives were to highlight the need for the prevention of MRSA infections and also emphasize the role of vaccination in the prevention of MRSA infections in India.
Electronic databases such as PubMed and databases of the National Institute of Science Communication and Information Resources and Indian Council of Medical Research Embase were searched for relevant literature published from 2005/01/01 to 2020/05/13 in English language, according to the predefined inclusion and exclusion criteria. A manual search was also conducted using the key term "MRSA 'or' Methicillin Resistant 'and' India." An independent reviewer extracted data from the studies using a structured Microsoft Excel spreadsheet, and a meta-analysis of proportion for MRSA prevalence with a corresponding 95% confidence interval (CI) for all included individual studies were performed.
A total of 34 studies involving 16 237 patients were included in the final meta-analysis. The pooled proportion of patients with MRSA infection was 26.8% (95% CI: 23.2%-30.7%). The MRSA infection was more prevalent among male patients (60.4%; 95% CI: 53.9%-66.5%) as compared to female patients (39.6%; 95% CI: 33.5%-46.1%), while the prevalence of MRSA was higher among adults (18 years and above; 32%; 95% CI: 5%-80%) in comparison to pediatric patients (0-18 years; 68%; 95% CI: 20%-94.8%). The degree of heterogeneity was found to be significant.
The prevalence of MRSA in India was relatively high at 27% with a higher proportion observed among men aged >18 years. The high prevalence of MRSA infections in India necessitates the implementation of surveillance and preventive measures to combat the spread of MRSA in both hospital and community settings.
本系统评价和荟萃分析旨在评估耐甲氧西林金黄色葡萄球菌（MRSA）的患病率、负担及流行病学情况。该系统评价还旨在突出印度（所有年龄组）耐甲氧西林金黄色葡萄球菌（MRSA）诊断和管理方面的挑战。我们还研究了已发表的关于印度MRSA现有治疗选择及预防作用的文献。通过总结当前可得数据，我们的目标是强调预防MRSA感染的必要性，并强调疫苗接种在印度预防MRSA感染中的作用。
根据预定义的纳入和排除标准，检索电子数据库，如PubMed以及国家科学传播与信息资源研究所数据库和印度医学研究理事会的Embase，以查找2005年1月1日至2020年5月13日以英文发表的相关文献。还使用关键词“MRSA '或' 耐甲氧西林 '和' 印度”进行了手动检索。一名独立评审员使用结构化的Microsoft Excel电子表格从研究中提取数据，并对所有纳入的个体研究进行MRSA患病率比例的荟萃分析及相应的95%置信区间（CI）。
最终的荟萃分析共纳入34项涉及16237名患者的研究。MRSA感染患者的合并比例为26.8%（95%CI：23.2%-30.7%）。与女性患者（39.6%；95%CI：33.5%-46.1%）相比，MRSA感染在男性患者中更为普遍（60.4%；%CI：53.9%-66.5%）；与儿科患者（0-18岁；68%；95%CI：20%-94.8%）相比，MRSA在成人（18岁及以上；32%；95%CI：5%-80%）中患病率更高。发现异质性程度显著。
印度MRSA的患病率相对较高，为27%，在年龄大于18岁的男性中比例更高。印度MRSA感染的高患病率使得有必要实施监测和预防措施，以应对MRSA在医院和社区环境中的传播。
