Methicillin Resistant Staphylococcus Aureus Carrier Status among Indian Healthcare Workers: A Systematic Review and Meta-Analysis

Abstract

Infection with Methicillin Resistant Staphylococcus aureus (MRSA) is a threat to quality care in the hospital.
Asymptomatic colonization of MRSA escalates the burden of infection. The rate of MRSA colonization
among healthcare workers (HCW) is not homogenous across the globe. Even though there are individual
study reports on MRSA colonization, no pooled data is available in India. Therefore, it is important to
evaluate the problem of MRSA colonization to develop a policy on preventive measures. We performed
a systematic review and meta-analysis of MRSA carrier status among Indian HCWs using five databases
(Scopus, PubMed-Medline, IndMed, CINAHL and Google-Scholar) from the articles published from 2008
to 2017 (10 years). STATA 13.0 with metaprop package in STATA was used to find the rate of colonization.
Among 2,349 HCWs, the pooled prevalence of MRSA colonization in throat, nose, axilla, palm, fingertips
and web-spaces was nine percent (CI 6% - 13%; p=0.001, I2
91.68%). Further, the forest plot of MRSA
colonization in nasal cavity alone was performed, and the prevalence of nasal colonization of MRSA among
1,251 Indian HCWs was found to be 11% (CI 5-17%, p=0.001, I2 93.3%). The colonization rate is not very
high nor negligible. Therefore, the hospital administrator along with the hospital infection control committee
needs to formulate a policy on periodic screening and decolonization of HCWs in high-risk areas.