Relationship between livestock exposure and methicillin-resistant Staphylococcus aureus carriage in humans: A systematic review and dose-response meta-analysis

Liu, Y. and Han, C. and Chen, Z. and Guo, D. and Ye, X.

Int J Antimicrob Agents (2020) 55: 105810

DOI: 10.1016/j.ijantimicag.2019.09.014

Abstract

Although previous studies have suggested an association between livestock exposure and the risk of methicillin-resistant Staphylococcus aureus (MRSA) carriage in humans, it remains unclear whether there is a dose-response relationship. The aim of this study was to evaluate the relationship between livestock exposure and MRSA carriage. Pooled risk estimates were calculated using fixed-effects or random-effects models based on homogeneity analysis. A dose-response meta-analysis based on linear and non-linear regression was performed to explore the frequency-risk relationship between livestock exposure and MRSA carriage. Subgroup analyses were conducted to explore sources of heterogeneity among eligible studies. A total of 25 studies were included in the meta-analysis. Livestock exposure was significantly associated with an increased risk of MRSA carriage [odds ratio (OR) = 7.03, 95% confidence interval 4.29-11.52], and similar positive associations were observed for pig (OR = 11.41), poultry (OR = 6.20) and cattle (OR = 5.66) exposure. Regarding studies on ordinal and continuous frequency of livestock exposure, a monotonically increasing frequency-risk relationship between livestock (or pig) exposure and MRSA carriage was consistently observed. This study found a monotonically increasing frequency-risk relationship between livestock exposure and MRSA carriage, which provides evidence for potential livestock-to-human transmission of MRSA.

Citation

Liu, Y., Han, C., Chen, Z., Guo, D., & Ye, X. (2020). Relationship between livestock exposure and methicillin-resistant Staphylococcus aureus carriage in humans: A systematic review and dose-response meta-analysis. Int J Antimicrob Agents, 55(1), 105810. https://doi.org/10.1016/j.ijantimicag.2019.09.014 Animals, Humans, Swine, Poultry, Livestock, Risk, Staphylococcus aureus, Human, Methicillin/pharmacology, Livestock/*microbiology, Methicillin-resistant, Methicillin-Resistant Staphylococcus aureus/*physiology, Mrsa, Staphylococcal Infections/microbiology/*transmission

Keywords

• Animals
• Humans
• Swine
• Poultry
• Livestock
• Risk
• Staphylococcus aureus
• Human
• Methicillin/pharmacology
• Livestock/*microbiology
• Methicillin-resistant
• Methicillin-Resistant Staphylococcus aureus/*physiology
• Mrsa
• Staphylococcal Infections/microbiology/*transmission