title: A meta-analysis of the rates of Staphylococcus aureus and methicillin-resistant S aureus contamination on the surfaces of environmental objects that health care workers frequently touch.
abstract: BACKGROUND
  Health care workers may potentially spread Staphylococcus aureus and methicillin-resistant S aureus (MRSA) to patients by contaminated high-touch items. We aimed to determine the pooled rates of S aureus and MRSA contamination and influencing factors.
  
  
  METHODS
  A literature search of the PubMed, ScienceDirect, Embase, Ovid, and Scopus databases was performed. Pooled contamination rates were determined using random effect models. Subgroup and meta-regression analyses were conducted to identify factors potentially influencing the rates of S aureus and MRSA contamination. Sensitivity and publication bias analyses were performed.
  
  
  RESULTS
  Thirty-eight studies were included in the meta-analysis. The pooled contamination rates were 15.0% (95% confidence interval [CI], 9.8%-21.1%) for S aureus and 5.0% (95% CI, 2.7%-7.7%) for MRSA. The subgroup analyses indicated that the pooled rate of S aureus contamination was significantly higher for studies conducted in South America, in developing countries, and during 2010-2015. The pooled rate of MRSA contamination was significantly higher for studies conducted in Africa. The meta-regression analysis suggested that the pooled rate of S aureus contamination was lower for studies conducted in developed countries (odds ratio, 0.664; 95% CI, 0.509-0.867; P = .004). No bias was found in the publication of the rates of S aureus and MRSA contamination.
  
  
  CONCLUSIONS
  S aureus and MRSA contamination statuses of high-touch items are worrisome and should be paid greater attention. Developing country status was a risk factor for S aureus contamination.
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Dongxin
authors.initials: D
authors.lastname: Lin
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Qianting
authors.initials: Q
authors.lastname: Ou
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China.
authors.forename: Jialing
authors.initials: J
authors.lastname: Lin
authors.affiliation: Centre for Chronic Diseases, University of Queensland, Brisbane, QLD, Australia.
authors.forename: Yang
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Epidemiology and Health Statistics, Guangdong Pharmaceutical University, Guangzhou, China. Electronic address: zhjyao2001@yahoo.com.
authors.forename: Zhenjiang
authors.initials: Z
authors.lastname: Yao
mesh_terms: D000349:Africa; D000569:Americas; D004783:Environmental Microbiology; D050456:Fomites / Q000382:microbiology*; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D016106:Methicillin Resistance; D013020:South America; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D014110:Touch
keywords: Contamination; Health care worker; High-touch item; Methicillin-resistant Staphylococcus aureus; Staphylococcus aureus