Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran.
Microb Pathog. 2022 Oct;171:105743. doi: 10.1016/j.micpath.2022.105743. Epub 2022 Aug 28.
Methicillin-resistant Staphylococcus aureus (MRSA) infection during pregnancy can adversely influence the well-being of pregnant women, fetuses, and neonates. To our knowledge, there is no global data on the maternal prevalence of MRSA colonization. We conducted a systematic review and meta-analysis to estimate the global and regional prevalence rates of MRSA colonization among pregnant women. We searched international databases (i.e., MEDLINE/PubMed, EMBASE, Scopus, Web of Science collection, and SciELO) for studies published from inception to March 10, 2022. Observational population-based studies reporting MRSA colonization among pregnant women were eligible to be included. We utilized the random-effects meta-analyses to compute the pooled prevalence estimates of maternal colonization across studies at 95% confidence intervals (CIs). The heterogeneity was assessed by I statistic and the Cochran's Q test. Subgroup and meta-regression analyses were used to adjust for potential sources of heterogeneity. The data source regarding maternal MRSA colonization included 55 studies from 24 countries and 110,654 pregnant women. The worldwide pooled prevalence for maternal MRSA colonization was 3.23% (95% CI, 2.40-4.17%), with the highest and lowest colonization rates for Africa (9.13%, 4.36-15.34%) and Europe (0.79%, 0.28-1.51%), respectively. We estimated that nearly 4.5 million pregnant women are colonized with MRSA worldwide. MRSA colonization rates were higher among black ethnicity, multiparous women, pregnant women with prior MRSA infection, women with lower personal hygiene, and those living in lower-income and human development indices countries or regions. MRSA colonizes substantial numbers of pregnant women worldwide, with varying prevalence rates in different regions; however, further investigations are needed to recognize regional differences. Our findings emphasized the need for prevention efforts against MRSA to reduce the health risks among women and newborns.
耐甲氧西林金黄色葡萄球菌（MRSA）感染在怀孕期间可能会对孕妇、胎儿和新生儿的健康产生不良影响。据我们所知，目前尚无全球范围内孕妇 MRSA 定植的患病率数据。我们进行了一项系统评价和荟萃分析，以估计全球和地区孕妇 MRSA 定植的患病率。我们检索了国际数据库（即 MEDLINE/PubMed、EMBASE、Scopus、Web of Science 集合和 SciELO），以获取从成立到 2022 年 3 月 10 日发表的研究。符合纳入标准的研究是指报告孕妇中存在 MRSA 定植的观察性人群研究。我们使用随机效应荟萃分析计算了研究之间的母体定植的汇总患病率，置信区间为 95%（CI）。通过 I 统计量和 Cochran's Q 检验评估异质性。使用亚组和荟萃回归分析来调整潜在的异质性来源。关于孕妇 MRSA 定植的数据来源包括来自 24 个国家的 55 项研究和 110654 名孕妇。全球范围内孕妇 MRSA 定植的总体流行率为 3.23%（95%CI，2.40-4.17%），非洲（9.13%，4.36-15.34%）和欧洲（0.79%，0.28-1.51%）的定植率最高和最低。我们估计，全世界有近 450 万孕妇定植了 MRSA。在黑种人、多产妇、有既往 MRSA 感染的孕妇、个人卫生水平较低的孕妇以及生活在低收入和人类发展指数较低的国家或地区的孕妇中，MRSA 定植率更高。MRSA 在全球范围内定植了大量孕妇，不同地区的流行率不同；然而，需要进一步调查以识别地区差异。我们的研究结果强调了需要针对 MRSA 采取预防措施，以降低妇女和新生儿的健康风险。
