Comprehensive Assessment of Risk Factors Associated with Methicillin-Resistant Staphylococcus aureus (MRSA) Infection in Asia: A Systematic Review

Main Article Content

Gilbert Lazarus
Jessica Audrey

Abstract

Background Antibiotic resistance persists as a global health challenge, among which methicillin-resistant Staphylococcus aureus (MRSA) is the most common and serious threat. Although certain control strategies have been implemented, the incidence and prevalence of MRSA remain high, especially in Asia


Objective To analyze the risk factors associated with MRSA infection in Asia


Methods A systematic review was conducted through PubMed, Scopus, and EBSCOhost, searching for observational studies which analyze the risk factors associated with MRSA infection in Asia. Studies selected were reviewed and assessed with STROBE’s criteria.


Results Sixteen observational studies were included, with a total of 10,253 subjects, consisting of 4 cohort studies, 4 cross-sectional studies, and 8 case-control studies. We find that certain social behaviors, such as sharing of personal items, limited daily activities and exposure to post-surgery individuals increases the risk of MRSA infection. Antibiotics use, especially when used extensively, is also found to elevate the risk. Furthermore, invasive medical procedures ease the entry of MRSA into the body, thus increasing risk of infection.


Conclusion The knowledge of these factors is hoped to help in establishing guidelines for infection prevention and control strategies, helping to halt the rise in antibiotics resistance, as well as reducing the prevalence of MRSA infection worldwide.

Article Details

How to Cite
Lazarus, G. and Audrey, J. (2019) “Comprehensive Assessment of Risk Factors Associated with Methicillin-Resistant Staphylococcus aureus (MRSA) Infection in Asia: A Systematic Review”, Journal of Asian Medical Students’ Association. Kuala Lumpur, Malaysia, 7(1). Available at: https://jamsa.amsa-international.org/index.php/main/article/view/162 (Accessed: 27April2024).
Section
Review and Meta-analysis

References

Hassoun A, Linden PK, Friedman B. Incidence, prevalence, and management of MRSA bacteremia across patient populations–a review of recent developments in MRSA management and treatment. Crit Care. 2017;21:211

Tong SYC, Davis JS, Eichenberger E, Holland TL, Fowler VG. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin Microbiol Rev. 2015 Jul;28(3):603-61

Chen CJ, Huang YC. New epidemiology of Staphylococcus aureus infection in Asia. Clin Microbiol Infect. 2014 Jul;20(7):605-23

Harkins CP, Pichon B, Doumith M, Parkhill J, Westh H, Tomasz A, et al. Methicillin-resistant Staphylococcus aureus emerged long before the introduction of methicillin into clinical practice. Genome Biol. 2017;18:130

Lee AS, Huttner B, Harbarth S. Prevention and control of methicillin-resistant Staphylococcus aureus in acute care settings. Infect Dis Clin North Am. 2016 Dec;30(4):931-52

Parathon H, Kuntaman K, Widiastoety TH, Muliawan BT, Karuniawati A, Qibtiyah M, et al. Progress towards antimicrobial resistance containment and control in Indonesia. BMJ. 2017;358:j3808

Suh HJ, Park WB, Jung S, Song K, Kwak YG, Kim K, et al. A risk-scoring system for predicting methicillin resistance in community-onset Staphylococcus aureus bacteremia in Korea. Microb Drug Resist. 2018 Jun;24(5):556-62

Shirai Y, Arai H, Tamaki K, Konishi H, Kawase Y, Shimizu N, et al. Neonatal methicillin-resistant Staphylococcus aureus colonization and infection. J Neonatal Perinatal Med. 2017;10(4):439-44

Yoon YK, Park DW, Sohn JW, Kim HY, Kim YS, Lee CS, et al. Effects of inappropriate empirical antibiotic therapy on mortality in patients with healthcare-associated methicillin-resistant Staphylococcus aureus bacteremia: a propensity-matched analysis. BMC Infect Dis. 2016 Jul 15;16:331

Gu FF, Zhang J, Zhao SY, Yang ZR, Zhang YL, Xiao SZ, et al. Risk factors for methicillin-resistant Staphylococcus aureus carriage among residents in 7 nursing homes in Shanghai, China. Am J Infect Control. 2016 Jul 1;44(7):805-8

Wong JG, Chen Mi, Win MK, Ng PY, Chow A. Length of stay an important mediator of hospital-acquired methicillin-resistant Staphylococcus aureus. Epidemiol Infect. 2016 Apr;144(6):1248-56

Yao Z, Peng Y, Chen X, Bi J, Li Y, Ye X, et al. Healthcare associated infections of methicillin-resistant Staphylococcus aureus: a case-control-control study. PLoS One. 2015 Oct 15;10(10):e0140604

Chou YH, Lee MS, Lin RY, Wu CY. Risk factors for methicillin-resistant Staphylococcus aureus skin and soft-tissue infections in outpatients in Taiwan. Epidemiol Infect. 2015 Mar;143(4):749-53

Jung WJ, Kang YA, Park MS, Park SC, Leem AY, Kim EY, et al. Prediction of methicillin-resistant Staphylococcus aureus in patients with non-nosocomial pneumonia. BMC Infect Dis. 2013 Aug 9;13:370

Leung YH, Lai RW, Chan AC, Lo JY, Wong MM, Chuang SK, et al. Risk factors for community-associated methicillin-resistant Staphylococcus aureus infection in Hong Kong. J Infect. 2012 May;64(5):494-9.

Wang CY, Wu VC, Wang WJ, Lin YF, Lin YH, Chen YM, et al. Risk factors for nasal carriage of methicillin-resistant Staphylococcus aureus among patients with end-stage renal disease in Taiwan. J Formos Med Assoc. 2012 Jan;111(1):14-8.

Lu S, Chang F, Cheng C, Lee K, Huang Y. Methicillin-resistant Staphylococcus aureus nasal colonization among adult patients visiting emergency department in a medical center in Taiwan. PLoS One. 2011; 6(6): e1862

Al-Talib HI, Yean CY, Al-Jashamy K, Hasan H. Methicillin-resistant Staphylococcus aureus nosocomial infection trends in Hospital Universiti Sains Malaysia during 2002-2007. Ann Saudi Med. 2010 Sep-Oct;30(5):358-63

Wang SH, Sun ZL, Guo YJ, Yang BQ, Yuan Y, Wei Q, et al. Meticillin-resistant Staphylococcus aureus isolated from foot ulcers in diabetic patients in a Chinese care hospital: risk factors for infection and prevalence. J Med Microbiol. 2010 Oct;59(10):1219-24

Gadepalli R, Dhawan B, Kapil A, Sreenivas V, Jais M, Gaind R, et al. Clinical and molecular characteristics of nosocomial meticillin-resistant Staphylococcus aureus skin and soft tissue isolates from three Indian hospitals. J Hosp Infect. 2009 Nov;73(3):253-63

Lo WT, Lin WJ, Tseng MH, Wang SR, Chu ML, Wang CC. Risk factors and molecular analysis of panton-valentine leukocidin-positive methicillin-resistant Staphylococcus aureus colonization in healthy children. Pediatr Infect Dis J. 2008 Aug;27(8):713-8

Washio M, Mizoue T, Kajioka T, Yoshimitsu T, Okayama M, Hamada T, et al. Risk factors for methicillin-resistant Staphylococcus aureus (MRSA) infection in a Japanese geriatric hospital. Public Health. 1997 May;111(3):187-90

Gordon RJ, Lowy FD. Pathogenesis of methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis. 2008 Jun 1;46(Suppl5):350-9

Grice EA, Segre JA. The skin microbiome. Nat Rev Microbiol. 2011 Apr;9(4):244-53

Tacconelli E, de Angelis G, Cataldo MA, Pozzi E, Cauda R. Does antibiotic exposure increase the risk of methicillin-resistant Staphylococcus aureus (MRSA) isolation? A systematic review and meta-analysis. J Antimicrob Chemother. 2008 Jan 1;61(1):26-38

Johnson AP. Surveillance of antibiotic resistance. Philos Trans R Soc Lond B Biol Sci. 2015 Jun 5;370(1670):20140080

Mehta Y, Gupta A, Todi S, Myatra SN, Samaddar DP, Patil V, et al. Guidelines for prevention of hospital acquired infections. Indian J Crit Care Med. 2014 Mar;18(3):149-63

Freeman MC, Stocks ME, Cumming O, Jeandron A, Higgins JP, Wolf J. Hygiene and health: systematic review of handwashing practices worldwide and update of health effects. Trop Med Int Health. 2014 Aug;19(8):906-16