Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant health threat and public burden worldwide, particularly in developing countries, including Nepal, due to its low healthcare standards and irrational use of antibiotics. It is evident that MRSA strains are frequently dete...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-02-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971220324632 |
| _version_ | 1818675715769368576 |
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| author | Ashok Khanal Sulochan G.C. Amrit Gaire Aashis Khanal Rolando Estrada Rakesh Ghimire Suresh Panthee |
| author_facet | Ashok Khanal Sulochan G.C. Amrit Gaire Aashis Khanal Rolando Estrada Rakesh Ghimire Suresh Panthee |
| author_sort | Ashok Khanal |
| collection | DOAJ |
| description | Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant health threat and public burden worldwide, particularly in developing countries, including Nepal, due to its low healthcare standards and irrational use of antibiotics. It is evident that MRSA strains are frequently detected in Nepalese hospitals; however, they remain underreported. Therefore, to provide a comprehensive and clear understanding of MRSA infection at the national level, this systematic review and meta-analysis evaluated the prevalence and antimicrobial susceptibility patterns of MRSA in Nepal. Methods: PubMed, EMBASE, Cochrane CENTRAL, Google scholar, and Nepalese databases were searched for studies published between 1st January 2008 and 31st August 2020. A total of 26 original articles were selected for quantitative analysis. Data extraction was accomplished by three authors independently and meta-analysis was performed using MedCalc Version 19.5.1 and Comprehensive Meta-Analysis (CMA) software v.3.0. Result: The pooled prevalence of MRSA infections among 5951 confirmed S. aureus isolates was 38.2% (95% CI, 31.4%–45.2%). We found a significant heterogeneity (I2 = 96.7% for resistance proportion), and no evidence of publication bias (p = 0.256) among studies. MRSA strains showed a high level of resistance to beta-lactam antibiotics and the highest susceptibility profile was noted in vancomycin 98.0% followed by chloramphenicol 91.0%. Conclusion: The analysis revealed that the overall MRSA burden in Nepal is considerably high and the prevalence of MRSA infections is in the increasing trend. Sound legislation, definite antibiotic policy, and implementations of control interventions are indispensable for tackling MRSA infection and antimicrobial resistance as a whole. |
| first_indexed | 2024-12-17T08:31:59Z |
| format | Article |
| id | doaj.art-394c71e307cf4dd095bec6a03ba8fe5c |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-12-17T08:31:59Z |
| publishDate | 2021-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-394c71e307cf4dd095bec6a03ba8fe5c2022-12-21T21:56:35ZengElsevierInternational Journal of Infectious Diseases1201-97122021-02-011034855Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysisAshok Khanal0Sulochan G.C.1Amrit Gaire2Aashis Khanal3Rolando Estrada4Rakesh Ghimire5Suresh Panthee6Maharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, Nepal; Active Pharmacy Pvt. Ltd., Kathmandu, NepalMaharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, NepalMaharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, NepalDepartment of Computer Science, Georgia State University, Atlanta, USADepartment of Computer Science, Georgia State University, Atlanta, USAMaharajgunj Medical Campus, Tribhuvan University Institute of Medicine, Kathmandu, NepalSustainable Study and Research Institute, Kathmandu-16, Balaju, Nepal; Corresponding author.Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant health threat and public burden worldwide, particularly in developing countries, including Nepal, due to its low healthcare standards and irrational use of antibiotics. It is evident that MRSA strains are frequently detected in Nepalese hospitals; however, they remain underreported. Therefore, to provide a comprehensive and clear understanding of MRSA infection at the national level, this systematic review and meta-analysis evaluated the prevalence and antimicrobial susceptibility patterns of MRSA in Nepal. Methods: PubMed, EMBASE, Cochrane CENTRAL, Google scholar, and Nepalese databases were searched for studies published between 1st January 2008 and 31st August 2020. A total of 26 original articles were selected for quantitative analysis. Data extraction was accomplished by three authors independently and meta-analysis was performed using MedCalc Version 19.5.1 and Comprehensive Meta-Analysis (CMA) software v.3.0. Result: The pooled prevalence of MRSA infections among 5951 confirmed S. aureus isolates was 38.2% (95% CI, 31.4%–45.2%). We found a significant heterogeneity (I2 = 96.7% for resistance proportion), and no evidence of publication bias (p = 0.256) among studies. MRSA strains showed a high level of resistance to beta-lactam antibiotics and the highest susceptibility profile was noted in vancomycin 98.0% followed by chloramphenicol 91.0%. Conclusion: The analysis revealed that the overall MRSA burden in Nepal is considerably high and the prevalence of MRSA infections is in the increasing trend. Sound legislation, definite antibiotic policy, and implementations of control interventions are indispensable for tackling MRSA infection and antimicrobial resistance as a whole.http://www.sciencedirect.com/science/article/pii/S1201971220324632Methicillin-resistantStaphylococcus aureusMRSASystematic reviewMeta-analysisAntimicrobial susceptibility |
| spellingShingle | Ashok Khanal Sulochan G.C. Amrit Gaire Aashis Khanal Rolando Estrada Rakesh Ghimire Suresh Panthee Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis International Journal of Infectious Diseases Methicillin-resistant Staphylococcus aureus MRSA Systematic review Meta-analysis Antimicrobial susceptibility |
| title | Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis |
| title_full | Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis |
| title_fullStr | Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis |
| title_full_unstemmed | Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis |
| title_short | Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis |
| title_sort | methicillin resistant staphylococcus aureus in nepal a systematic review and meta analysis |
| topic | Methicillin-resistant Staphylococcus aureus MRSA Systematic review Meta-analysis Antimicrobial susceptibility |
| url | http://www.sciencedirect.com/science/article/pii/S1201971220324632 |
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