Reducing transmission of methicillin-resistant Staphylococcus aureus in a surgical ward of a resource-limited hospital in Indonesia: an intervention study

Occurrence, multidrug resistance and potential risk factors for Staphylococcus aureus infection at worker-animal and working equipment interfaces: a systematic review and meta-analysis of the Ethiopian literature

Background

Staphylococcus aureus (S. aureus) infecting animals and humans via close contact, handling, or consuming contaminated products is a growing public health concern. In Ethiopia, it is important to examine the overall prevalence of S. aureus, patterns of multidrug resistance, and potential risks in human-animal interface settings. Thus, this review was conducted to estimate the pooled prevalence of S. aureus, its multidrug resistance, and potential risk factors for worker-animal-working equipment interactions.

Methods

This systematic review and meta-analysis were carried out by the PRISMA guidelines. The research articles were searched from PubMed, HINARI, Web of Sciences, and Google Scholar databases.

Results

This meta-analysis included 13 independent articles and 52 dependent studies. In total, 5,329 humans, 5,475 animals, and 5,119 samples of working equipment were analyzed. The pooled prevalence of S. aureus at the interfaces between humans, animals, and working equipment was 22%, there was a high level of heterogeneity (I2 = 94%: p < 0.01). The overall pooled prevalence of S. aureus in dairy farm sources was 23% (95% CI, 17-30%) compared to 18% in abattoirs. The pooled prevalence of S. aureus was estimated to be 25% for human sources, 23% for animal sources, and 19% for working equipment. The total multidrug resistance (MDR) rate was 27%. The present study illustrates that a predominant antimicrobials comprising ampicillin, penicillin, chloramphenicol, tetracycline, and ciprofloxacin, accounts for the development of resistance in S. aureus strains, with a prevalence of 72%. According to the qualitative assessment of potential risk factors, animal age, worker education, lactation stage, and hand washing by milkers influenced the circulation of S. aureus at animal-worker and working equipment interfaces.

Conclusion

The pooled prevalence of S. aureus at the interface of human,-and animal-working equipment was quantified at 22%. S. aureus was found in humans, animals, and equipment at nearly the same rate. The results of this study demonstrate that S. aureus is hazardous and circulates among animals, workers, and equipment: farmers, animal owners, employees, and the public need to be educated about S. aureus. Moreover, animals and work equipment should be included in the control and prevention of S. aureus infection.

Diversity and Dissemination of Methicillin-Resistant Staphylococcus aureus (MRSA) Genotypes in Southeast Asia

Methicillin-resistant Staphylococcus aureus (MRSA) is a successful pathogen that has achieved global dissemination, with high prevalence rates in Southeast Asia. A huge diversity of clones has been reported in this region, with MRSA ST239 being the most successful lineage. Nonetheless, description of MRSA genotypes circulating in the Southeast Asia region has, until now, remained poorly compiled. In this review, we aim to provide a better understanding of the molecular epidemiology and distribution of MRSA clones in 11 Southeast Asian countries: Singapore, Malaysia, Thailand, Vietnam, Cambodia, Lao People's Democratic Republic (PDR), Myanmar, Philippines, Indonesia, Brunei Darussalam, and Timor-Leste. Notably, while archaic multidrug-resistant hospital-associated (HA) MRSAs, such as the ST239-III and ST241-III, were prominent in the region during earlier observations, these were then largely replaced by the more antibiotic-susceptible community-acquired (CA) MRSAs, such as ST22-IV and PVL-positive ST30-IV, in recent years after the turn of the century. Nonetheless, reports of livestock-associated (LA) MRSAs remain few in the region.

Dangerous Pathogens as a Potential Problem for Public Health

Pathogens are various organisms, such as viruses, bacteria, fungi, and protozoa, which can cause severe illnesses to their hosts. Throughout history, pathogens have accompanied human populations and caused various epidemics. One of the most significant outbreaks was the Black Death, which occurred in the 14th century and caused the death of one-third of Europe's population. Pathogens have also been studied for their use as biological warfare agents by the former Soviet Union, Japan, and the USA. Among bacteria and viruses, there are high priority agents that have a significant impact on public health. Bacillus anthracis, Francisella tularensis, Yersinia pestis, Variola virus, Filoviruses (Ebola, Marburg), Arenoviruses (Lassa), and influenza viruses are included in this group of agents. Outbreaks and infections caused by them might result in social disruption and panic, which is why special operations are needed for public health preparedness. Antibiotic-resistant bacteria that significantly impede treatment and recovery of patients are also valid threats. Furthermore, recent events related to the massive spread of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are an example of how virus-induced diseases cannot be ignored. The impact of outbreaks, such as SARS-CoV-2, have had far-reaching consequences beyond public health. The economic losses due to lockdowns are difficult to estimate, but it would take years to restore countries to pre-outbreak status. For countries affected by the 2019 coronavirus disease (COVID-19), their health systems have been overwhelmed, resulting in an increase in the mortality rate caused by diseases or injuries. Furthermore, outbreaks, such as SARS-CoV-2, will induce serious, wide-ranging (and possibly long-lasting) psychological problems among, not only health workers, but ordinary citizens (this is due to isolation, quarantine, etc.). The aim of this paper is to present the most dangerous pathogens, as well as general characterizations, mechanisms of action, and treatments.