scholarly journals Prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) infection in patients with Cystic Fibrosis: a meta-analysis

2019 ◽  
Author(s):  
Sagad Omer Obeid Mohamed ◽  
Almigdad H. M. Ali ◽  
Abazr A. H. Ibrahim ◽  
Mahmoud Elnil ◽  
Almutasim B. E. Elhassan ◽  
...  

Abstract Background Methicillin-resistant staphylococcus aureus (MRSA) infection is increasingly being reported among patients with cystic fibrosis (CF) and contributes to pulmonary morbidity in CF, with poorer prognosis. The aim of this study was to assess the prevalence of MRSA infection in patients with CF. Methods We conducted this study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases of MEDLINE/PubMed, WHO-Virtual Health Library (VHL), ScienceDirect, Google Scholar and OpenGrey were searched to recruit the relevant articles. Pooled prevalence with the corresponding 95% confidence interval (CI) was calculated using OpenMeta Analyst software, and heterogeneity among studies was estimated using the I2 statistics. Results According to our inclusion criteria, 27 studies included a total of 47,413 patients were analyzed. The pooled prevalence of MRSA in patients with CF was 15.2% (95% CI 9.70%– 20.7%). Subgroup analyses and meta-regression showed that the prevalence of MRSA in patients with CF was significantly associated with different geographical areas (P<0.001), data collection method (P<0.001), sample obtaining source (P<0.001), and study year (P = 0.006). Conclusions prevalence of MRSA infection is increasing in patients with CF. the results of this study could provide a reference for further controlling transmission and the management of patients with CF. Healthcare providers need to be aware of the clinically important association between MRSA infection and CF to ensure effective management.

Author(s):  
Jacquelyn Brondo ◽  
Kathleen Morneau ◽  
Teri Hopkins ◽  
Linda Yang ◽  
Jose Cadena-Zuluaga ◽  
...  

Infectious Diseases Society of America diabetic foot infection (DFI) guidelines indicate empiric methicillin-resistant Staphylococcus aureus (MRSA) coverage for patients with a history of MRSA infection, when local prevalence of MRSA is high, or infection is clinically severe. These recommendations may lead to overutilization of empiric MRSA coverage, which can result in serious consequences. A strong negative predictive value (NPV) has been reported in literature for pneumonia, and recently, for all anatomical sites of infection. While these findings are promising, further validation is needed before clinicians may confidently use MRSA nares to guide empiric therapy for DFIs. A retrospective electronic medical record review was completed between October 1, 2013 and October 1, 2019. Patients met inclusion criteria if they were at least 18, admitted with a DFI, had MRSA nares test results, and DFI cultures. Patients were excluded if pregnant or MRSA infection within 1 year prior to index admission for DFI. A total of 200 patients met inclusion criteria. The majority of study participants were male with a mean age of 63. NPV of MRSA nares for MRSA DFIs was determined to be 94% and positive predictive value 58%. Sensitivity and specificity were 56% and 94%, respectively. Results of this study are consistent with prior literature supporting strong correlation of NPV for MRSA nares. The DFIs evaluated suggest a strong NPV of MRSA nares for MRSA DFIs, which may allow for faster de-escalation of empiric anti-MRSA antibiotic therapy and lower risk of adverse events associated with anti-MRSA therapy.


2020 ◽  
Author(s):  
Zhouqi Li ◽  
Hemu Zhuang ◽  
Guannan Wang ◽  
Hui Wang ◽  
Ying Dong

Abstract Background: Cancer patients are more likely to develop and die of bloodstream infection (BSI) than noncancer patients. Methicillin-resistant Staphylococcus aureus (MRSA), which is associated with immense mortality and economic burden worldwide, is not covered by the recommended initial antibiotic therapy for cancer patients with BSI. This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia.Methods: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020 that provided primary data on the prevalence, predictors, or mortality of MRSA bacteremia in cancer patients. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs).Results: The pooled prevalence of MRSA was 3% (95% CI 2–5%) among all bloodstream infections (BSIs) and 44% (95% CI 32–57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1–14%), 1% in Americas (95% CI 1–2%), 2% in Europe (95% CI 1–4%), 4% in Western Pacific (95% CI 2–7%), 8% in South-east Asia (95% CI 4–14%) and 0% in Eastern Mediterranean (95% CI 0–3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P=0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2g/mL being the risk factors for mortality.Conclusions: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.


2020 ◽  
Vol 13 ◽  
pp. 117863372097056
Author(s):  
Canna Jagdish Ghia ◽  
Shaumil Waghela ◽  
Gautam Rambhad

Aim and objective: This systematic review and meta-analysis was conducted to assess the prevalence, burden and epidemiology of methicillin-resistant S. aureus (MRSA). This systemic review was also aimed to highlight the challenges in the diagnosis and management of methicillin-resistant S. aureus (MRSA) in India (for all age groups). We also examined the published literature on the available treatment options and the role of prevention in the management of MRSA in India. By summarizing the currently available data, our objectives were to highlight the need for the prevention of MRSA infections and also emphasize the role of vaccination in the prevention of MRSA infections in India. Methodology: Electronic databases such as PubMed and databases of the National Institute of Science Communication and Information Resources and Indian Council of Medical Research Embase were searched for relevant literature published from 2005/01/01 to 2020/05/13 in English language, according to the predefined inclusion and exclusion criteria. A manual search was also conducted using the key term “MRSA ‘or’ Methicillin Resistant Staphylococcus aureus ‘and’ India.” An independent reviewer extracted data from the studies using a structured Microsoft Excel spreadsheet, and a meta-analysis of proportion for MRSA prevalence with a corresponding 95% confidence interval (CI) for all included individual studies were performed. Result: A total of 34 studies involving 16 237 patients were included in the final meta-analysis. The pooled proportion of patients with MRSA infection was 26.8% (95% CI: 23.2%-30.7%). The MRSA infection was more prevalent among male patients (60.4%; 95% CI: 53.9%-66.5%) as compared to female patients (39.6%; 95% CI: 33.5%-46.1%), while the prevalence of MRSA was higher among adults (18 years and above; 32%; 95% CI: 5%-80%) in comparison to pediatric patients (0-18 years; 68%; 95% CI: 20%-94.8%). The degree of heterogeneity was found to be significant. Conclusion: The prevalence of MRSA in India was relatively high at 27% with a higher proportion observed among men aged >18 years. The high prevalence of MRSA infections in India necessitates the implementation of surveillance and preventive measures to combat the spread of MRSA in both hospital and community settings.


2018 ◽  
Vol 81 (7) ◽  
pp. 1055-1062 ◽  
Author(s):  
CLAUDIA M. RIBEIRO ◽  
LENITA M. STEFANI ◽  
SIMONE B. LUCHEIS ◽  
WERNER OKANO ◽  
JULIANO CEZAR M. CRUZ ◽  
...  

ABSTRACT Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that colonizes and infects various host species and has been found in the poultry production chain, raising concerns about possible transmission from farm to fork. The objective of this study was to use meta-analytical methods to estimate the pooled prevalence of MRSA in chickens, turkeys, chicken meat, and turkey meat. Three electronic databases (PubMed, LILACS, and SciELO) were searched to establish MRSA prevalence from 51 studies published from 2003 through May 2017. The heterogeneity was assessed, and the pooled MRSA prevalence was calculated by using the random effects model according to the method of DerSimonian and Laird. Pooled MRSA prevalence (95% confidence interval [CI]) in turkeys, turkey meat, broilers, and chicken meat was 36% (1 to 78%), 13% (1 to 28%), 5% (2 to 9%), and 5% (3 to 8%), respectively. South America had the highest MRSA prevalence (27%; 95% CI, 17 to 37%), and North America had the lowest (1%; 95% CI, 0 to 2%). Livestock-associated MRSA has been isolated from poultry and poultry meat, indicating that this variant can spread from farm to fork. The presence of MRSA in poultry and poultry meat poses risks to public health, and steps should be taken to mitigate the contamination and spread of this bacterium along the poultry production chain.


2021 ◽  
Author(s):  
Zhouqi Li ◽  
Hemu Zhuang ◽  
Guannan Wang ◽  
Hui Wang ◽  
Ying Dong

Abstract Background: Cancer patients are more likely to develop and die of bloodstream infection (BSI) than noncancer patients. Methicillin-resistant Staphylococcus aureus (MRSA), which is associated with immense mortality and economic burden worldwide, is not covered by the recommended initial antibiotic therapy for cancer patients with BSI. This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia. Methods: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020 that provided primary data on the prevalence, predictors, or mortality of MRSA bacteremia in cancer patients. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs).Results: The pooled prevalence of MRSA was 3% (95% CI 2–5%) among all bloodstream infections (BSIs) and 44% (95% CI 32–57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1–14%), 1% in Americas (95% CI 1–2%), 2% in Europe (95% CI 1–4%), 4% in Western Pacific (95% CI 2–7%), 8% in South-east Asia (95% CI 4–14%) and 0% in Eastern Mediterranean (95% CI 0–3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P=0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2g/mL being the risk factors for mortality.Conclusions: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.


2020 ◽  
Author(s):  
Zhouqi Li ◽  
Hemu Zhuang ◽  
Guannan Wang ◽  
Hui Wang ◽  
Ying Dong

Abstract Background: Cancer patients are more likely to develop and die of bloodstream infection (BSI) than noncancer patients. Methicillin-resistant Staphylococcus aureus (MRSA), which is associated with immense mortality and economic burden worldwide, is not covered by the recommended initial antibiotic therapy for cancer patients with BSI. This systemic review was performed to estimate the global methicillin-resistant Staphylococcus aureus (MRSA) prevalence among bacteremia in patients with malignancy, and further study the predictors and mortality of cancer patients with MRSA bacteremia. Methods: The PubMed and EMBASE databases were searched for studies published from Jan. 2000 to Mar. 2020 that provided primary data on the prevalence, predictors, or mortality of MRSA bacteremia in cancer patients. A random-effects model meta-analysis was performed to estimate the pooled prevalence of MRSA with 95% confidence intervals (95% CIs).Results: The pooled prevalence of MRSA was 3% (95% CI 2–5%) among all bloodstream infections (BSIs) and 44% (95% CI 32–57%) among S. aureus bacteremia in cancer patients. Based on geographical stratification, the pooled prevalence was 5% in Africa (95% CI 1–14%), 1% in Americas (95% CI 1–2%), 2% in Europe (95% CI 1–4%), 4% in Western Pacific (95% CI 2–7%), 8% in South-east Asia (95% CI 4–14%) and 0% in Eastern Mediterranean (95% CI 0–3%). No significant temporal change in MRSA rates was detected in this analysis (R2 = 0.06; P=0.24). Predictors for MRSA BSIs among cancer patients were identified by comparison with their methicillin-susceptible counterparts, and they were mainly related to healthcare-associated infections and immunosuppression. Finally, the 60-day mortality in adult cancer patients with MRSA BSIs was reported to be 12%, and the 6-month overall mortality was 43.2%, with community-onset infection, secondary BSI, and vancomycin MIC≥2g/mL being the risk factors for mortality.Conclusions: Although the prevalence of MRSA BSIs among cancer patients is relatively low, it did not decline over time as MRSA BSIs in the general hospital population and the high mortality rate was related to MRSA BSIs in patients with malignancy.


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