title: The prevalence and influencing factors of methicillin-resistant Staphylococcus aureus carriage in people in contact with livestock: A systematic review.
abstract: BACKGROUND
  Methicillin-resistant Staphylococcus aureus (MRSA) is becoming a serious epidemic worldwide. Recently, studies have shown that people in contact with livestock may have a greater chance of MRSA carriage. We aimed to establish the prevalence of MRSA among people in contact with livestock and review the factors influencing MRSA carriage.
  
  
  METHODS
  We systematically examined published epidemiologic studies on MRSA prevalence in people in contact with livestock using Pubmed, Medline, Embase, Ovid, and the Cochrane Library. Prevalence estimates were pooled using a random-effects model. Study heterogeneity was assessed using Q statistics and quantified with I(2) statistics.
  
  
  RESULTS
  Thirty-three eligible studies were included in this systematic review. Prevalence of MRSA ranged from 0.0%-85.8%. The pooled prevalence estimate of MRSA was 14.2% (95% confidence interval, 9.1%-20.1%) for people in contact with livestock. Substantial heterogeneity in eligible studies was noted (χ(2) = 1,025; P < .001; I(2) = 96.9%). Subgroup analysis showed the prevalence of MRSA was high in people from Europe (15.9%), farmers (18.2%), and by longitudinal study design (38.9%). Animal contact and intensity of animal contact were associated with increased risk of MRSA carriage.
  
  
  CONCLUSIONS
  Our findings suggest that there may be transmission of MRSA between animals and humans.
authors: Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
authors: Weidong
authors: W
authors: Liu
authors: Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
authors: Zhichang
authors: Z
authors: Liu
authors: Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
authors: Zhenjiang
authors: Z
authors: Yao
authors: Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
authors: Yanping
authors: Y
authors: Fan
authors: Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China.
authors: Xiaohua
authors: X
authors: Ye
authors: Guangdong Key Laboratory of Molecular Epidemiology, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China. Electronic address: chensidong1@126.com.
authors: Sidong
authors: S
authors: Chen
mesh_terms: D000818:Animals; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D058751:Livestock; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D016273:Occupational Exposure; D015995:Prevalence; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology
keywords: Epidemiology; Human; Livestock; MRSA