Table 4.
Characteristics of eligible studies analysing fecal carriage of Staphylococcus aureus or MRSA from the healthcare setting.
| Study population setting | Participants screened for fecalΨ carriage (n) | Participant characteristics | Sample collection | Laboratory technique(s) | S. aureus detection | MRSA detection | Reference | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age range | Health status | Exposure to healthcare setting 12 months prior to screening† | Sample type | Age at which samples were collected | Site at which samples were collected | S. aureus detection | MRSA detection | Genotyping | Virulence profile analysis | % (n/N) | & (n/N) | |||
| CATEGORY: IN-PATIENTS | ||||||||||||||
| France | 748 | Mean age: 55 years±12 | Liver cirrhosis | Hospitalized for minimum of 2 weeks | Feces | Mean age: 55 years±12 | Hospital | Phenotypic | Phenotypic | NP | NP | NR | 12 (93/748) | Campillo et al., 2001 |
| France | 327 | NR | Chronic liver disease, post-surgical patients, patients with alcohol withdrawal and digestive tract diseases | Patients transferred from other hospitals | Feces | NR | Hospital | Phenotypic and Molecular | Phenotypic | PFGE | NP | NR | 11 (36/327) | Dupeyron et al., 2002 |
| Germany | 2727 | NR | Nosocomial diarrhea | ≥72 h at the time of study | Feces | NR | Hospital | Phenotypic | Phenotypic | NP | SE | 7 (198/2727) | 15 (29/198) | Flemming and Ackermann, 2007 |
| Germany | 131 | NR | NR | Inpatients positive for MRSA | Rectal swabs | NR | Hospital | Phenotypic and Molecular | Phenotypic and Molecular | PFGE | SE | NR | 47 (61/131) | Klotz et al., 2005 |
| Jordan | 214 | ≤28 days to 1 year | NR | NR | Feces | ≤28 days to 1 year | NICU | Phenotypic | Phenotypic | SCCmec typing | ET | 2 (5/214) | 20 (1/5) | Shehabi et al., 2013 |
| PVL | ||||||||||||||
| SE | ||||||||||||||
| TSST | ||||||||||||||
| Saudi Arabia | 122 | NR | NR | ≥72 h at the time of study | Feces | NR | Hospital | Phenotypic | Phenotypic | NP | NP | NA | 7 (9/122) | Babay and Somily, 2009 |
| United States of America | 810 (2000-01) | NR | Cancer | Inpatientsφ | Rectal swabs | NR | Hospital | Phenotypic and Molecular | Phenotypic | spa typing | PVL | NR | 0.6 (5/810)φ | Srinivasan et al., 2010 |
| MLST | ||||||||||||||
| 925 (2006-07) | PFGE | 2.9 (27/925)φ | ||||||||||||
| United States of America | 161 | 57–103 years | Fecal and urinary in-continence, pressure ulcers, diabetes, COPD, heart failure | Long-term care facility residents | Rectal swabs | 57-103 years | Long-term care wards | NP | Phenotypic | PFGE | NP | NA | 3 (4/161) | O'Fallon et al., 2009 |
| United States of America | 37 | 48–91 years | Chronic renal failure, diabetes, chronic dermato-logic infections | Inpatients positive for VRE | Feces | 48 to 91 years | Hospital | Phenotypic | Phenotypic | PFGE | NP | 62 (23/37) | 87 (20/23) | Ray et al., 2003 |
| United States of America | 114 | NR | NR | Skilled-care patients admitted for long-term care | Rectal swabs | Hospital | Phenotypic | Phenotypic | PFGE | NP | NR | 5 (6/114) | Trick et al., 2001 | |
| CATEGORY: HEALTHCARE PERSONNEL | ||||||||||||||
| United States of America | 62 | >18 years | Healthy pregnant women at 35–37 weeks of pregnancy | Noφ | Rectal swabs | > 18 years | Obstetric clinics | Phenotypic | Phenotypic and Molecular | SCCmec typing | PVL | 3 (2/62)φ | 0 (0/2)φ | Andrews et al., 2009 |
| PFGE | ||||||||||||||
| United States of America | 55 | 36 years±11 | NR | Nurses (n = 29), Physicians (n = 15), Others (n = 9), Unknown (n = 2) (mean patient contact years: 13 years±9) | Fecal | 36 years±11 | NR | NP | Phenotypic | NP | NP | NA | 0 (0/55) | Carmeli et al., 1998 |
Fecal samples, rectal swabs, anal swabs, peri-rectal or peri-anal swabs.
Hospital, long-term care facility, nursing homes, maternity wards.
Information obtained from the author.
Phenotypic identification: culture characteristics on mannitol salt agar, Baird-Parker agar, Tripticase soy agar, Chapman agar, Staphylococcus medium 110, positive results for Gram stain, catalase, coagulase and DNase Tests.
agr, Accessory gene regulator; AUR, Aureolysisn; BAP, biofilm-associated protein; CNA, collagen-binding protein; COPD, chronic obstructive pulmonary disorder; ET, Exfoliative toxins; MLVA, Multiple-locus variable-number tandem repeat analysis; MRSA, methicillin resistant Staphylococcus aureus; NICU, Neonatal intensive care unit; NR, Not reported; NP, Not performed; NA, Not applicable; PFGE: pulsed-field gel electrophoresis; PVL, Panton-Valentine Leukocidin; SCCmec, staphylococcal cassette chromosome mec; SE, Staphylococcal enterotoxins; spa, Staphylococcus aureus protein A; TSST, Toxic shock syndrome toxin; VRE, Vancomycin-resistance enterococci.