PDF(Pubmed)
Abstract：
UNASSIGNED: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant cause of morbidity and mortality among neonates admitted to neonatal intensive care units (NICUs). The MRSA colonization of neonates, attributed to various sources, including mothers, healthcare workers, and environmental surfaces, can lead to severe infection, prolonged hospital stays, and even death, imposing substantial economic burdens. Given the pressing need to mitigate MRSA spread in these vulnerable environments, further examination of the subject is warranted. This systematic review is aimed at synthesizing available evidence on MRSA carriage proportions among mothers of newborns, healthcare workers, and environmental surfaces in NICUs. Methodology. We included observational studies published in English or French from database inception to March 21, 2023. These studies focused on MRSA in nonoutbreak NICU settings, encompassing healthy neonate mothers and healthcare workers, and environmental surfaces. Literature search involved systematic scanning of databases, including Medline, Embase, Web of Science, Global Health, and Global Index Medicus. The quality of the selected studies was assessed using the Hoy et al. critical appraisal scale. The extracted data were summarized to calculate the pooled proportion of MRSA positives, with a 95% confidence interval (CI) based on the DerSimonian and Laird random-effects model.
UNASSIGNED: A total of 1891 articles were retrieved from which 16 studies were selected for inclusion. Most of the studies were from high-income countries. The pooled proportion of MRSA carriage among 821 neonate mothers across four countries was found to be 2.1% (95% CI: 0.3-5.1; I2 = 76.6%, 95% CI: 36.1-91.5). The proportion of MRSA carriage among 909 HCWs in eight countries was determined to be 9.5% (95% CI: 3.1-18.4; I2 = 91.7%, 95% CI: 87.1-94.6). The proportion of MRSA carriage among HCWs was highest in the Western Pacific Region, at 50.00% (95% CI: 23.71-76.29). In environmental specimens from five countries, a pooled proportion of 16.6% (95% CI: 3.5-36.0; I2 = 97.7%, 95% CI: 96.6-98.4) was found to be MRSA-positive.
UNASSIGNED: With a significant heterogeneity, our systematic review found high MRSA carriage rates in neonate mothers, healthcare workers, and across various environmental surfaces in NICUs, posing a potential risk of nosocomial infections. Urgent interventions, including regular screening and decolonization of MRSA carriers, reinforcing infection control measures, and enhancing cleaning and disinfection procedures within NICUs, are crucial. This trial is registered with CRD42023407114.
UNASSIGNED: A total of 1891 articles were retrieved from which 16 studies were selected for inclusion. Most of the studies were from high-income countries. The pooled proportion of MRSA carriage among 821 neonate mothers across four countries was found to be 2.1% (95% CI: 0.3-5.1; I2 = 76.6%, 95% CI: 36.1-91.5). The proportion of MRSA carriage among 909 HCWs in eight countries was determined to be 9.5% (95% CI: 3.1-18.4; I2 = 91.7%, 95% CI: 87.1-94.6). The proportion of MRSA carriage among HCWs was highest in the Western Pacific Region, at 50.00% (95% CI: 23.71-76.29). In environmental specimens from five countries, a pooled proportion of 16.6% (95% CI: 3.5-36.0; I2 = 97.7%, 95% CI: 96.6-98.4) was found to be MRSA-positive.
UNASSIGNED: With a significant heterogeneity, our systematic review found high MRSA carriage rates in neonate mothers, healthcare workers, and across various environmental surfaces in NICUs, posing a potential risk of nosocomial infections. Urgent interventions, including regular screening and decolonization of MRSA carriers, reinforcing infection control measures, and enhancing cleaning and disinfection procedures within NICUs, are crucial. This trial is registered with CRD42023407114.
摘要：
耐甲氧西林金黄色葡萄球菌（MRSA）是新生儿重症监护病房（NICU）新生儿发病和死亡的重要原因。新生儿MRSA定植，归因于各种来源，包括母亲,医护人员,和环境表面，会导致严重感染,住院时间延长,甚至死亡,造成巨大的经济负担。鉴于迫切需要缓解MRSA在这些脆弱环境中的传播，有必要对该主题进行进一步检查。本系统评价旨在综合新生儿母亲中MRSA携带比例的现有证据。医护人员,和NICU中的环境表面。方法论。我们纳入了从数据库开始到2023年3月21日以英语或法语发表的观察性研究。这些研究集中在非暴发NICU环境中的MRSA，包括健康的新生儿母亲和医护人员，和环境表面。文献检索涉及对数据库的系统扫描，包括Medline,Embase,WebofScience,全球卫生,和全球指数药物。使用Hoy等人评估所选研究的质量。关键评估量表。汇总提取的数据以计算MRSA阳性的合并比例，基于DerSimonian和Laird随机效应模型，置信区间(CI)为95%。
■共检索到1891篇文章，从中选择了16项研究。大多数研究来自高收入国家。发现四个国家的821名新生儿母亲中MRSA携带的合并比例为2.1％（95％CI：0.3-5.1；I2=76.6％，95%CI：36.1-91.5）。在8个国家的909名HCWs中，MRSA的携带比例确定为9.5%(95%CI:3.1-18.4；I2=91.7%，95%CI：87.1-94.6）。在西太平洋地区，HCW中MRSA的携带比例最高，50.00%（95%CI：23.71-76.29）。在来自五个国家的环境标本中，合并比例为16.6%(95%CI：3.5-36.0；I2=97.7%，95%CI：96.6-98.4）发现MRSA阳性。
■具有显著的异质性，我们的系统评价发现，新生儿母亲的MRSA携带率高，医护人员,在NICU的各种环境表面上，构成医院感染的潜在风险。紧急干预，包括MRSA携带者的定期筛查和去定植，加强感染控制措施，并加强NICU内的清洁和消毒程序，是至关重要的。该试验已在CRD42023407114注册。
■共检索到1891篇文章，从中选择了16项研究。大多数研究来自高收入国家。发现四个国家的821名新生儿母亲中MRSA携带的合并比例为2.1％（95％CI：0.3-5.1；I2=76.6％，95%CI：36.1-91.5）。在8个国家的909名HCWs中，MRSA的携带比例确定为9.5%(95%CI:3.1-18.4；I2=91.7%，95%CI：87.1-94.6）。在西太平洋地区，HCW中MRSA的携带比例最高，50.00%（95%CI：23.71-76.29）。在来自五个国家的环境标本中，合并比例为16.6%(95%CI：3.5-36.0；I2=97.7%，95%CI：96.6-98.4）发现MRSA阳性。
■具有显著的异质性，我们的系统评价发现，新生儿母亲的MRSA携带率高，医护人员,在NICU的各种环境表面上，构成医院感染的潜在风险。紧急干预，包括MRSA携带者的定期筛查和去定植，加强感染控制措施，并加强NICU内的清洁和消毒程序，是至关重要的。该试验已在CRD42023407114注册。
