The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis
Siyuan Zhou,1,2 Xiaojie Hu,1,2 Yunfei Wang,1,2 Wenting Fei,2 Yuqin Sheng,2 Huafa Que1,2 1Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Longhua Clinical Medical College, Shanghai Un...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2024-02-01
|
| Series: | Diabetes, Metabolic Syndrome and Obesity |
| Subjects: | |
| Online Access: | https://www.dovepress.com/the-global-prevalence-of-methicillin-resistant-staphylococcus-aureus-i-peer-reviewed-fulltext-article-DMSO |
| _version_ | 1797325397562490880 |
|---|---|
| author | Zhou S Hu X Wang Y Fei W Sheng Y Que H |
| author_facet | Zhou S Hu X Wang Y Fei W Sheng Y Que H |
| author_sort | Zhou S |
| collection | DOAJ |
| description | Siyuan Zhou,1,2 Xiaojie Hu,1,2 Yunfei Wang,1,2 Wenting Fei,2 Yuqin Sheng,2 Huafa Que1,2 1Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Longhua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Huafa Que, Department of Traditional Chinese Surgery, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 725, Wanping South Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 18917763260, Email huafaque@126.comObjective: Diabetic foot ulcer (DFU) frequently leads to infections, with infected DFUs being a common cause of amputation. Infection by methicillin-resistant Staphylococcus aureus (MRSA) notably increases the necessity for amputation and surgical debridement in affected individuals. Consequently, determining the prevalence and trends of MRSA in patients with DFU is of critical importance. This study aimed to assess the global prevalence and to identify trends in the occurrence of MRSA in tissue or wound swab samples from DFU patients.Methods: We conducted a comprehensive literature search across PubMed, Embase, Scopus, and Ovid, spanning from the inception of these databases to July 2023, imposing no language restrictions. The inclusion criteria required that the studies report on 30 or more patients with DFU. Additionally, we categorized our analysis based on geographic region, publication date, and the economic status of the patient’s domicile. Our primary endpoint was to ascertain the prevalence of MRSA in DFUs. This systematic review has been registered at (https://www.crd.york.ac.uk/prospero/), with the identifier CRD 42023444360.Results: Our analysis encompassed 40 studies involving 12,924 patients across 20 countries. We found that the overall prevalence of MRSA in DFU was 17% (95% Confidence Interval [CI] 0.14– 0.20). Regional prevalence varied significantly: in South America, it was 61% (95% CI 0.46– 0.76), in North America 20% (95% CI 0.12– 0.27), in Europe 19% (95% CI 0.14– 0.25), in Africa 13% (95% CI 0.06– 0.20), and in other subgroups 11% (95% CI 0.08– 0.15). The prevalence of MRSA in DFUs also differed according to the economic status of the countries: 19% (95% CI 0.15– 0.23) in high-income countries, 24% (95% CI 0.1– 0.37) in upper-middle-income countries, 11% (95% CI 0.07– 0.15) in lower-middle-income countries, and 20% (95% CI 0.13– 0.27) in low-income countries. Notably, there has been a decline in MRSA prevalence, from 25% before 2010 to 9% thereafter.Conclusion: This meta-analysis reveals a decreasing yet still significant global prevalence of MRSA in DFUs. This trend has important implications for antimicrobial resistance and underscores the need for developing targeted programs focusing on infection prevention and exploring alternative therapeutic strategies.Keywords: diabetic foot ulcers, global prevalence, epidemiological trends, systematic review, meta-analysis |
| first_indexed | 2024-03-08T06:08:54Z |
| format | Article |
| id | doaj.art-ca78ecfd4af646e1b4dbd848f624ad9e |
| institution | Directory Open Access Journal |
| issn | 1178-7007 |
| language | English |
| last_indexed | 2024-03-08T06:08:54Z |
| publishDate | 2024-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Diabetes, Metabolic Syndrome and Obesity |
| spelling | doaj.art-ca78ecfd4af646e1b4dbd848f624ad9e2024-02-04T17:43:33ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072024-02-01Volume 1756357490222The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-AnalysisZhou SHu XWang YFei WSheng YQue HSiyuan Zhou,1,2 Xiaojie Hu,1,2 Yunfei Wang,1,2 Wenting Fei,2 Yuqin Sheng,2 Huafa Que1,2 1Department of Traditional Chinese Surgery, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 2Longhua Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Huafa Que, Department of Traditional Chinese Surgery, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, No. 725, Wanping South Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 18917763260, Email huafaque@126.comObjective: Diabetic foot ulcer (DFU) frequently leads to infections, with infected DFUs being a common cause of amputation. Infection by methicillin-resistant Staphylococcus aureus (MRSA) notably increases the necessity for amputation and surgical debridement in affected individuals. Consequently, determining the prevalence and trends of MRSA in patients with DFU is of critical importance. This study aimed to assess the global prevalence and to identify trends in the occurrence of MRSA in tissue or wound swab samples from DFU patients.Methods: We conducted a comprehensive literature search across PubMed, Embase, Scopus, and Ovid, spanning from the inception of these databases to July 2023, imposing no language restrictions. The inclusion criteria required that the studies report on 30 or more patients with DFU. Additionally, we categorized our analysis based on geographic region, publication date, and the economic status of the patient’s domicile. Our primary endpoint was to ascertain the prevalence of MRSA in DFUs. This systematic review has been registered at (https://www.crd.york.ac.uk/prospero/), with the identifier CRD 42023444360.Results: Our analysis encompassed 40 studies involving 12,924 patients across 20 countries. We found that the overall prevalence of MRSA in DFU was 17% (95% Confidence Interval [CI] 0.14– 0.20). Regional prevalence varied significantly: in South America, it was 61% (95% CI 0.46– 0.76), in North America 20% (95% CI 0.12– 0.27), in Europe 19% (95% CI 0.14– 0.25), in Africa 13% (95% CI 0.06– 0.20), and in other subgroups 11% (95% CI 0.08– 0.15). The prevalence of MRSA in DFUs also differed according to the economic status of the countries: 19% (95% CI 0.15– 0.23) in high-income countries, 24% (95% CI 0.1– 0.37) in upper-middle-income countries, 11% (95% CI 0.07– 0.15) in lower-middle-income countries, and 20% (95% CI 0.13– 0.27) in low-income countries. Notably, there has been a decline in MRSA prevalence, from 25% before 2010 to 9% thereafter.Conclusion: This meta-analysis reveals a decreasing yet still significant global prevalence of MRSA in DFUs. This trend has important implications for antimicrobial resistance and underscores the need for developing targeted programs focusing on infection prevention and exploring alternative therapeutic strategies.Keywords: diabetic foot ulcers, global prevalence, epidemiological trends, systematic review, meta-analysishttps://www.dovepress.com/the-global-prevalence-of-methicillin-resistant-staphylococcus-aureus-i-peer-reviewed-fulltext-article-DMSOdiabetic foot ulcersglobal prevalenceepidemiological trendssystematic reviewmeta-analysis |
| spellingShingle | Zhou S Hu X Wang Y Fei W Sheng Y Que H The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis Diabetes, Metabolic Syndrome and Obesity diabetic foot ulcers global prevalence epidemiological trends systematic review meta-analysis |
| title | The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis |
| title_full | The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis |
| title_fullStr | The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis |
| title_short | The Global Prevalence of Methicillin-Resistant Staphylococcus Aureus in Patients with Diabetic Foot Ulcers: A Systematic Review and Meta-Analysis |
| title_sort | global prevalence of methicillin resistant staphylococcus aureus in patients with diabetic foot ulcers a systematic review and meta analysis |
| topic | diabetic foot ulcers global prevalence epidemiological trends systematic review meta-analysis |
| url | https://www.dovepress.com/the-global-prevalence-of-methicillin-resistant-staphylococcus-aureus-i-peer-reviewed-fulltext-article-DMSO |
| work_keys_str_mv | AT zhous theglobalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT hux theglobalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT wangy theglobalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT feiw theglobalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT shengy theglobalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT queh theglobalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT zhous globalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT hux globalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT wangy globalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT feiw globalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT shengy globalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis AT queh globalprevalenceofmethicillinresistantstaphylococcusaureusinpatientswithdiabeticfootulcersasystematicreviewandmetaanalysis |