Abstract
We evaluated the gene prevalence of the icaADBC operon, its correlation with biofilm formation and antibiotic resistance through a global meta-analysis. We searched for articles that reported the prevalence of icaADBC operon, biofilm, and antibiotic resistance in S. aureus from 2000 up to 1(st) March 2024. The search was done in scientific databases such as PubMed, Scopus, Google Scholar, EMBASE, and Web of Science. The MESH keywords were: icaADBC operon, biofilm, methicillin-resistant Staphylococcus aureus, antibiotic resistance. Comprehensive Meta-Analysis Software was used for data analysis. The estimation of the combined prevalence of each desired variable was performed by depicting a forest plot through the random-effects model with a 95% confidence interval. Data heterogeneity was estimated by Q and I(2) indices, and p-value <0.05 was reflected as statistically significant heterogeneity. Fifteen articles were eligible for inclusion. The prevalence of ica operon genes varied between 28-51.5%. The prevalence of total ica operon genes in S. aureus was reported at 42.4% (95%CI: 29.4-56.5). Biofilm formation prevalence of S. aureus isolates in different studies was reported between 10-100%. The rate of total biofilm in S. aureus was 95.8%. The rate of total strong, moderate, and weak biofilm in S. aureus was reported at 35.4%, 35.3%, and 23.9%, respectively. Most reviewed studies reported a correlation between ica genes and biofilm. We found that many studies reported a correlation between the high prevalence of ica operon genes, phenotypic biofilm production, and antibiotic resistance. Also, regardless of whether the strains were MRSA or not, the high biofilm formation ability was reported at 95.8% by most studies.