Prevalence and distribution of methicillin-resistant Staphylococcus aureus among animals in Malaysia for the past 15 years: A systematic review

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This systematic review aimed to investigate the prevalence and molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in animals, human-animal interfaces, their antibiotic resistance profiles, and genotypic characteristics of MRSA isolates reported in Malaysia over the last 15 years. A comprehensive search of PubMed, Scopus, and Web of Science databases was conducted to identify relevant studies published between 2008 and 2023. Sixteen eligible articles were included in the review, and the systematic review protocol was published in Prospero (registration number: CRD42023432959). The prevalence of S. aureus, including MRSA, ranged from 0.95% to 100% among all the studies reviewed (poultry: 0.95% to 100%, cattle: 10% to 25%, pigs: 0.8% to 18.3%, sheep/goats: 18.3% to 46%). The MRSA isolates from Malaysian livestock production systems displayed pathogenic potential with diverse spa and sequence types. These isolates carried genes associated with virulence factors such as enterotoxins sea, seb, and exfoliative toxins eta, etb. One study reported the presence of the typical livestock-associated MRSA mecC gene. The review highlights the presence of potentially highly virulent strains of multi-drug-resistant MRSA in livestock, livestock products, and pets, which can be transmitted to high-risk individuals with frequent animal contact. Further studies are required to identify the impact of livestock on MRSA transmission and to understand the role of animals in the prevalence and occurrence of MRSA in Malaysia