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MRSA Nasal Colonization in Children: Prevalence Meta-analysis, Review of Risk Factors and Molecular Genetics

Gesualdo, Francesco MD*; Bongiorno, Dafne DBiol PhD; Rizzo, Caterina MD; Bella, Antonino DStat; Menichella, Donato MD*; Stefani, Stefania PhD; Tozzi, Alberto E. MD*

The Pediatric Infectious Disease Journal: May 2013 - Volume 32 - Issue 5 - p 479–485
doi: 10.1097/INF.0b013e3182864e4c
Original Studies

Background: We report a meta-analysis of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization prevalence in children and a review of the risk factors as well as molecular genetic characterization.

Methods: All relevant studies reporting prevalence data on MRSA nasal colonization in children published between January 2000 and August 2010 were retrieved from the MEDLINE database and analyzed.

Results: After screening 544 studies, 50 studies were included. We obtained an estimate of MRSA prevalence of 2.7% (95% confidence interval [CI]: 2.2–3.1); of 5.2% (95% CI: 3.1–7.3) in children with underlying conditions and of 2.3% (95% CI: 1.8–2.7) in healthy children; 5.4% (95% CI: 3.1–7.7) in children recruited in hospitals and 3% (95% CI: 2.4–3.6) in children recruited in the community. Staphylococcal cassette chromosome mec type IV is the most diffused cassette globally.

Conclusion: The hospital remains the environment where the microorganism circulates most. Children with underlying conditions could act as vectors of microorganisms between the hospital and the community. MRSA prevention strategies should be tailored to each specific institution, taking into account the nosocomial prevalence of MRSA nasal colonization and infections, and the prevalence of nasal colonization in the community that refers to the specific health care center.

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From the *Bambino Gesù Children’s Hospital, Rome; Department of Bio-Medical Sciences, Section of Microbiology, University of Catania, Catania; and National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy.

Accepted for publication 05, 2013.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Francesco Gesualdo, MD, Epidemiology Unit, Ospedale Pediatrico Bambino Gesù, Piazza S. Onofrio 4, 00165 Rome, Italy. E-mail:

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© 2013 Lippincott Williams & Wilkins, Inc.