Prevalence of MRSA in Livestock, Including Cattle, Farm Animals, and Poultry, in Mainland China, Hong Kong Special Administrative Region, Sri Lanka, and Bangladesh: A Systematic Review and Meta-Analysis.

Methicillin-resistant (MRSA) can spread from animals to humans, but how it adapts to infect both is not fully understood. Our review aimed to determine the prevalence of MRSA in livestock, poultry, and companion animals in different countries, including Bangladesh, the Hong Kong SAR, Mainland China, and Sri Lanka. Articles were collected using PubMed, Embase, Web of Science, Scopus, CINAHL, and Google Scholar. Only prevalence studies that followed the PICO guidelines were included. A random-effects model meta-analysis was used to pool the data. The quality of the evidence and bias were assessed using the GRADEpro and Cochrane collaboration tools. Out of 1438 articles, 69 studies were eligible for meta-analysis. The studies showed significant heterogeneity ( = 97.00%, < 0.0001) in the prevalence of MRSA colonization. Therefore, a random-effects model was used to determine the pooled prevalence of MRSA colonization, which was found to be 4.92% (95% CI: 3.79% to 6.18%). Begg's test ( = 0.0002) and Egger's test ( = 0.0044) revealed publication bias. Subgroup analysis of the pooled prevalence of MRSA showed a significant difference ( < 0.00001) when the subgroups were divided by country, MRSA detection method, whether pre-enrichment was performed or not, study period, sample collection location, and study population. Although significant factors can partially explain the heterogeneity, it is crucial to recognize the heterogeneity within different subgroups. The pooled prevalence of MRSA was found to vary significantly ( < 0.00001) among the study periods and has increased since the study period of 2020. Therefore, it is crucial to continuously monitor and implement measures to control the spread of MRSA in animals to minimize the risk of transmission to humans.