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Updated: Mar 20, 2026
Methodology for the Study of Horizontal Gene Transfer in Staphylococcus aureus
Published on: March 10, 2017
Fecal Carriage of Staphylococcus aureus in the Hospital and Community Setting: A Systematic Review
Shantelle Claassen-Weitz1, Adebayo O Shittu2, Michelle R Ngwarai1
1Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town Cape Town, South Africa.
Background And Rationale:
Staphylococcus aureus fecal carriage has been identified as a potential source for nosocomial transmission and a risk factor for disease development. This systematic review determined the overall S. aureus [including methicillin susceptible and resistant S. aureus (MSSA and MRSA)] fecal carriage rates within the community and healthcare settings.
Methodology:
Peer-reviewed articles indexed in Medline, Scopus, Academic Search Premier, Africa-Wide Information, CINAHL, and Web of Science were identified using applicable and controlled vocabulary through to 11 November 2015. Eligible studies were ascertained by three independent reviewers. Random-effects meta-analyses of proportions were performed to determine S. aureus, MSSA and MRSA fecal carriage rates reported by eligible studies.
Results:
Twenty six studies were included in this review. The pooled estimates for S. aureus, MSSA and MRSA fecal carriage were 26% (95% confidence interval (CI): 16.8-36.3%), 86% (95% confidence interval (CI): 65.9-97.9%) and 10% (95% CI: 0.7-27.0%), respectively. Fecal S. aureus carriage rates increased on average from 10 to 65% during the first 8 weeks of life, followed by an average carriage rate of 64% at 6 months and 46% at 1 year of life. Genotyping techniques were employed mainly in studies conducted in developed countries and comprised largely of gel-based techniques. Six studies reported on the role of S. aureus fecal strains in diarrhea (n = 2) and the risk for acquiring infections (n = 4). Eight of the 26 studies included in this review performed antibiotic susceptibility testing of S. aureus fecal isolates.
Conclusion:
This study provides evidence that screening for S. aureus fecal carriage, at least in populations at high risk, could be an effective measure for the prevention of S. aureus transmission and infection in the healthcare and community setting. More well-structured studies need to be conducted and sequence-based genotyping techniques should be employed for the comparison of isolates on a global scale in both developing and developed countries.
Insights
Staphylococcus aureus fecal carriage is common, affecting 26% overall. Screening for S. aureus, including MRSA, may prevent transmission in healthcare and community settings.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Staphylococcus aureus fecal carriage is a reservoir for nosocomial transmission.
- It represents a significant risk factor for developing S. aureus-related diseases.
Purpose of the Study:
- To systematically review and determine the overall fecal carriage rates of S. aureus, including methicillin-susceptible (MSSA) and methicillin-resistant (MRSA) strains.
- To assess carriage rates in both community and healthcare settings.
Main Methods:
- Systematic review of peer-reviewed articles indexed in major databases (Medline, Scopus, etc.) up to November 2015.
- Random-effects meta-analyses of proportions were used to calculate pooled carriage rates for S. aureus, MSSA, and MRSA.
Main Results:
- The pooled fecal S. aureus carriage rate was 26% (95% CI: 16.8-36.3%).
- MSSA carriage was 86% (95% CI: 65.9-97.9%) and MRSA carriage was 10% (95% CI: 0.7-27.0%).
- Fecal S. aureus carriage rates showed a significant increase in infants during the first year of life.
Conclusions:
- Screening for S. aureus fecal carriage, especially in high-risk populations, can aid in preventing transmission and infection.
- Further well-designed studies using sequence-based genotyping are recommended for global comparisons.
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