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Al-Iede M, Ayyad DM, Etoom RA, Aldameiry RH, Toubasi AA. The prevalence and risk factors of methicillin-resistant Staphylococcus aureus among pediatric populations: a systematic review and meta-analysis. Eur J Pediatr 2024:10.1007/s00431-024-05672-7. [PMID: 38970703 DOI: 10.1007/s00431-024-05672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/22/2024] [Accepted: 06/26/2024] [Indexed: 07/08/2024]
Abstract
There is scarcity in the data about MRSA prevalence and risk factors among the pediatric population. This research explores the global prevalence and risk factors of MRSA among the pediatric population. PubMed, Scopus, Web of Sciences, and the Cochrane Central Register of Controlled Trials were systematically searched. Our primary goal was to assess the prevalence of MRSA colonization and its related risk factors in the general pediatric population. A total of 124 studies encompassing 44 million participants were included in this meta-analysis, and the overall pooled estimated global prevalence of MRSA colonization in pediatric was 5% [95% CI 4-5%]. Female sex (OR = 4.17; 95% CI, 3.31-5.27), recent surgery (OR = 3.79; 95% CI, 2.20-6.52), recent hospitalization (OR = 2.63; 95% CI, 1.78-3.86), and antibiotic use (OR = 2.42; 95% CI, 1.58-3.72) were significantly associated with higher odds of MRSA colonization. CONCLUSION Future research should build on these findings by emphasizing ongoing efforts to combat MRSA in pediatric settings and implementing targeted interventions. WHAT IS KNOWN • Methicillin-resistant Staphylococcus aureus (MRSA) is considered a threat to public health. It is noteworthy to mention that the prevalence of MRSA strains has not been adequately quantified in many countries, especially in the pediatric population. The pediatric population is a pivotal source of MRSA and may play a central role in its distribution in both community and healthcare settings. A notable study underscores the gravity of the situation, estimating a tenfold increase in the incidence of MRSA infection among children in the USA between 1999 and 2008. WHAT IS NEW • Here we present the first global systematic review and meta-analysis to investigate the prevalence and risk factors of MRSA among the pediatric population. A total of 124 studies encompassing 44 million participants were included in this analysis. The overall pooled estimated global prevalence of MRSA colonization in the pediatric population was 5% [95% CI 4-5%]. The prevalence was the highest in Asia and lowest in Europe. Female sex, recent surgery, recent hospitalization, and antibiotic use were significantly associated with higher odds of MRSA colonization.
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Affiliation(s)
- Montaha Al-Iede
- School of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan.
- Department of Pediatrics, Jordan University Hospital, Amman, Jordan.
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan.
| | - Dania M Ayyad
- School of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
| | - Rasha A Etoom
- School of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
| | - Rawaby H Aldameiry
- School of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
| | - Ahmad A Toubasi
- School of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, Jordan
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Prolonged silent carriage, genomic virulence potential and transmission between staff and patients characterize a neonatal intensive care unit (NICU) outbreak of methicillin-resistant Staphylococcus aureus (MRSA). Infect Control Hosp Epidemiol 2023; 44:40-46. [PMID: 35311638 DOI: 10.1017/ice.2022.48] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen in neonatal intensive care units (NICU) that confers significant morbidity and mortality. OBJECTIVE Improving our understanding of MRSA transmission dynamics, especially among high-risk patients, is an infection prevention priority. METHODS We investigated a cluster of clinical MRSA cases in the NICU using a combination of epidemiologic review and whole-genome sequencing (WGS) of isolates from clinical and surveillance cultures obtained from patients and healthcare personnel (HCP). RESULTS Phylogenetic analysis identified 2 genetically distinct phylogenetic clades and revealed multiple silent-transmission events between HCP and infants. The predominant outbreak strain harbored multiple virulence factors. Epidemiologic investigation and genomic analysis identified a HCP colonized with the dominant MRSA outbreak strain who cared for most NICU patients who were infected or colonized with the same strain, including 1 NICU patient with severe infection 7 months before the described outbreak. These results guided implementation of infection prevention interventions that prevented further transmission events. CONCLUSIONS Silent transmission of MRSA between HCP and NICU patients likely contributed to a NICU outbreak involving a virulent MRSA strain. WGS enabled data-driven decision making to inform implementation of infection control policies that mitigated the outbreak. Prospective WGS coupled with epidemiologic analysis can be used to detect transmission events and prompt early implementation of control strategies.
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Mohamadou M, Essama SR, Ngonde Essome MC, Akwah L, Nadeem N, Gonsu Kamga H, Sattar S, Javed S. High prevalence of Panton-Valentine leukocidin positive, multidrug resistant, Methicillin-resistant Staphylococcus aureus strains circulating among clinical setups in Adamawa and Far North regions of Cameroon. PLoS One 2022; 17:e0265118. [PMID: 35802616 PMCID: PMC9269376 DOI: 10.1371/journal.pone.0265118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/13/2022] [Indexed: 11/22/2022] Open
Abstract
Staphylococcus aureus (S. aureus) is one of the earliest pathogens involved in human infections, responsible for a large variety of pathologies. Methicillin was the first antibiotic used to treat infections due to S. aureus but infections due to Methicillin resistant Staphylococcus aureus (MRSA) originated from hospital settings. Later, severe infections due to MRSA without any contact with the hospital environment or health care workers arose. Prevalence of MRSA has shown an alarming increase worldover including Cameroon. This Cross-sectional study was designed to evaluate the occurrence of MRSA infections in five different, most frequented Hospitals in northern Cameroon. Socio demographic data was recorded through questionnaire and different clinical specimens were collected for bacterial isolation. Identification of S. aureus was confirmed via 16s rRNA amplification using S. aureus specific primers. Molecular characterisation was performed through mecA gene, Luk PV gene screening and SCCmec typing. A total of 380 S. aureus clinical isolates were obtained of which 202 (53.2%) were nonduplicate multidrug resistant isolates containing, 45.5% MRSA. Higher number of MRSA was isolated from pus (30.4%) followed by blood culture (18.5%), and urine (17.4%). Patients aged 15 to 30 years presented high prevalence of MRSA (30.4%). Majority isolates (97.8%) carried the mecA gene, PVL toxin screening indicated 53.3% isolates carried the lukPV gene. Based on PVL detection and clinical history, CA-MRSA represented 53.3% of isolates. SCCmec typing showed that the Type IV was most prevalent (29.3%), followed by type I (23.9%). Amongst MRSA isolates high resistance to penicillin (91.1%), cotrimoxazole (86.7%), tetracycline (72.2%), and ofloxacin (70.0%) was detected. Meanwhile, rifampicin, fusidic acid, lincomycin and minocycline presented high efficacy in bacterial control. This study revealed a high prevalence of MRSA among infections due to S. aureus in Northern Cameroon. All MRSA recorded were multidrug resistant and the prevalence of CA MRSA are subsequently increasing, among population.
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Affiliation(s)
- Mansour Mohamadou
- Biosciences Department, COMSATS University Islamabad, Islamabad, Pakistan
- Department of Microbiology, Faculty of Science, University of Yaounde 1, Yaoundé, Cameroon
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Sarah Riwom Essama
- Department of Microbiology, Faculty of Science, University of Yaounde 1, Yaoundé, Cameroon
| | - Marie Chantal Ngonde Essome
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Lillian Akwah
- Department of Microbiology, Faculty of Science, University of Yaounde 1, Yaoundé, Cameroon
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Nudrat Nadeem
- Biosciences Department, COMSATS University Islamabad, Islamabad, Pakistan
| | - Hortense Gonsu Kamga
- Department of Microbiology, Haematology and Infectious diseases, Faculty of Medicine and Biomedical Sciences of University of Yaounde 1, Yaoundé, Cameroon
| | - Sadia Sattar
- Biosciences Department, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sundus Javed
- Biosciences Department, COMSATS University Islamabad, Islamabad, Pakistan
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Hayat K, Jamshed S, Rosenthal M, Haq NU, Chang J, Rasool MF, Malik UR, Rehman AU, Khan KM, Fang Y. Understanding of Pharmacy Students towards Antibiotic Use, Antibiotic Resistance and Antibiotic Stewardship Programs: A Cross-Sectional Study from Punjab, Pakistan. Antibiotics (Basel) 2021; 10:66. [PMID: 33445511 PMCID: PMC7827071 DOI: 10.3390/antibiotics10010066] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 12/23/2022] Open
Abstract
Antibiotic resistance (ABR) is a significant issue for public health globally. An adequate understanding of ABR and the approaches used to tackle ABR, including antibiotic stewardship programs, are vital. This study aimed to get an insight into antibiotic use, ABR, and antibiotic stewardship programs among pharmacy students of Punjab, Pakistan. This multicenter study was undertaken among final (fifth) year undergraduate pharmacy students of 7 universities of Punjab, Pakistan. A paper-based self-administered questionnaire comprising 48-items was utilized for data collection. Descriptive and inferential statistics were employed for data analysis. This study included a total of 296 respondents with a response rate of 85.8%. Most of the students had an average understanding of antibiotic use (59.8%), ABR (42.6%), ABR mechanisms (48.0%), and factors of ABR (51.7%). Only 21.6% of students have heard about antibiotic stewardship programs. More than half of the students believed that educating and training healthcare professionals (53.4%) and medical students (57.8%) about the prescribing and judicial usage of antibiotics could reduce the ABR burden. The awareness of most of the pharmacy students about certain aspects of antibiotic use, ABR, and stewardship programs was suboptimal.
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Affiliation(s)
- Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China; (K.H.); (J.C.); (U.R.M.)
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an 710061, China
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan;
| | - Shazia Jamshed
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Terengganu 22200, Malaysia;
- Qualitative Research-Methodological Application in Health Sciences Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia (IIUM), Kuantan 25200, Malaysia
| | - Meagen Rosenthal
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS 38677, USA;
| | - Noman Ul Haq
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Balochistan, Quetta 87900, Pakistan;
| | - Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China; (K.H.); (J.C.); (U.R.M.)
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an 710061, China
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (M.F.R.); (A.U.R.)
| | - Usman Rashid Malik
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China; (K.H.); (J.C.); (U.R.M.)
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an 710061, China
| | - Anees Ur Rehman
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan 60800, Pakistan; (M.F.R.); (A.U.R.)
| | - Kashif Maqbool Khan
- Institute of Pharmaceutical Sciences, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan;
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an 710061, China; (K.H.); (J.C.); (U.R.M.)
- Center for Drug Safety and Policy Research, Xi’an Jiaotong University, Xi’an 710061, China
- Shaanxi Centre for Health Reform and Development Research, Xi’an 710061, China
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