Global epidemiology of asymptomatic colonisation of methicillin-resistant Staphylococcus aureus in the upper respiratory tract of young children: a systematic review and meta-analysis.

OBJECTIVE: To estimate the global prevalence of asymptomatic colonisation, and determine the associated risk factors, antibiotic resistance and genotypes of methicillin-resistant Staphylococcus aureus (MRSA) in the upper respiratory tract of young children. DESIGN: Four bibliometric databases were searched for publications between 2010 and 2022 according to the protocol registered in PROSPERO. Cross-sectional or cohort studies describing the prevalence of asymptomatic colonisation of S. aureus and MRSA in young children were included. Data extraction and analysis were carried out by two reviewers independently according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Pooled prevalence was estimated using a random effects model. SETTING AND STUDIES: We included studies where children without respiratory tract infection or Staphylococcal infection were recruited from the community, children's institutions (ie, nurseries, kindergartens, daycare centres and preschools) and healthcare centre visits and assessed for asymptomatic colonisation with S. aureus and MRSA. MAIN OUTCOME MEASURES: The pooled prevalence of asymptomatic colonisation of S. aureus and MRSA of young children globally. RESULTS: In this systematic review and meta-analysis of 21 416 young children, the pooled global prevalence of asymptomatic S. aureus colonisation was 25.1% (95% CI 21.4 to 28.8) and MRSA colonisation was 3.4% (95% CI 2.8 to 4.1). The clones of MRSA strains included healthcare-associated MRSA, community-associated MRSA and livestock-associated MRSA. CONCLUSION: This study provides evidence of increased MRSA colonisation globally among young children, underlining the critical role of asymptomatic carriers in MRSA transmission and the need for control measures. PROSPERO REGISTRATION NUMBER: CRD 42022328385.

Is there a role of faecal microbiota transplantation in reducing antibiotic resistance burden in gut? A systematic review and Meta-analysis.

OBJECTIVES: The aim of current systematic review and meta-analysis is to provide insight into the therapeutic efficacy of fecal microbiota transplantation (FMT) for the decolonization of antimicrobial-resistant (AMR) bacteria from the gut. METHODS: The protocol for this Systematic Review was prospectively registered with PROSPERO (CRD42020203634). Four databases (EMBASE, MEDLINE, SCOPUS, and WEB of SCIENCE) were consulted up until September 2020. A total of fourteen studies [in vivo (n = 2), case reports (n = 7), case series without control arm (n = 3), randomized clinical trials (RCT, n = 2)], were reviewed. Data were synthesized narratively for the case reports, along with a proportion meta-analysis for the case series studies (n = 102 subjects) without a control arm followed by another meta-analysis for case series studies with a defined control arm (n = 111 subjects) for their primary outcomes. RESULTS: Overall, seven non-duplicate case reports (n = 9 participants) were narratively reviewed and found to have broad AMR remission events at the 1-month time point. Proportion meta-analysis of case series studies showed an overall 0.58 (95% CI: 0.42-0.74) AMR remission. Additionally, a significant difference in AMR remission was observed in FMT vs treatment naïve (RR = 0.44; 95% CI: 0.20-0.99) and moderate heterogeneity (I2=65%). A subgroup analysis of RCTs (n = 2) revealed FMT with further benefits of AMR remission with low statistical heterogeneity (RR = 0.37; 95% CI: 0.18-0.79; I2 =23%). CONCLUSION: More rigorous RCTs with larger sample size and standardized protocols on FMTs for gut decolonization of AMR organisms are warranted.KEY MESSAGEExisting studies in this subject are limited and of low quality with moderate heterogeneity, and do not allow definitive conclusions to be drawn.More rigorous RCTs with larger sample size and standardized protocols on FMTs for gut decolonization of AMR organisms are warranted.

Vitamin A Fortified Edible Oils and Rice: The Knowledge Level and Consumption Rate among Different Place of Residences in Tangail District, Bangladesh.

A population based cross-sectional study was conducted in four residential areas of Tangail Sadar Upazila, Bangladesh aiming to explore the knowledge about vitamin A fortified edible oils and rice as well as the their consumption rate. A total of 400 participants were randomly selected. Data were collected through face to face interviews. Only 15.0% and 3.5% participants had knowledge about vitamin A fortified edible oils and rice respectively. Precisely vitamin A fortified edible oils knowledge level was found inferior in rural (11.7%) and slum (0%) than urban (48.3%) and semi-urban (40.0%) participants. Knowledge about vitamin A fortified rice was found higher in urban (78.6%) than rural (14.3%) and slum (0%) participants. Most of the participants received knowledge through advertisements (N=45 and N=12 for fortified oils and rice respectively). Maximum participants (62.3%) did not consume vitamin A fortified edible oils and consumption rate in rural (11.8%) and slum (10.2%) areas were poorer than urban (53.5%) and semi-urban (24.4%) areas. Consumption rate of vitamin A fortified rice was found nil in all the study areas. Lack of knowledge about vitamin A fortified rice and oils accounted solely for poor consumption. Knowledge level about vitamin A fortified edible oils and rice and consumption rate were found statistically significantly (p<0.05) with participant's place of residences, education level and monthly income. Finally, this study indicates that the overall knowledge level and consumption rate of vitamin A fortified edible oils and rice is poor especially in rural and slum populations in Tangail Sadar Upazila.