The Prevalence, Risk, and Management of Methicillin-Resistant Staphylococcus aureus Infection in Diverse Populations across Canada: A Systematic Review.

Elena Mitevska,Craig N Jenne,Britney Wong,Bas G J Surewaard

doi:10.3390/pathogens10040393

Elena Mitevska, Craig N Jenne + Show 2 more

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https://doi.org/10.3390/pathogens10040393

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Journal: Pathogens	Publication Date: Mar 25, 2021
Citations: 24	License type: CC BY 4.0

Affiliation: University of Calgary

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) first emerged after methicillin was introduced to combat penicillin resistance, and its prevalence in Canada has increased since the first MRSA outbreak in the early 1980s. We reviewed the existing literature on MRSA prevalence in Canada over time and in diverse populations across the country. MRSA prevalence increased steadily in the 1990s and 2000s and remains a public health concern in Canada, especially among vulnerable populations, such as rural, remote, and Indigenous communities. Antibiotic resistance patterns and risk factors for MRSA infection were also reported. All studies reported high susceptibility (>85%) to trimethoprim-sulfamethoxazole, with no significant resistance reported for vancomycin, linezolid, or rifampin. While MRSA continues to have susceptibility to several antibiotics, the high and sometimes variable resistance rates to other drugs underscores the importance of antimicrobial stewardship. Risk factors for high MRSA infection rates related to infection control measures, low socioeconomic status, and personal demographic characteristics were also reported. Additional surveillance, infection control measures, enhanced anti-microbial stewardship, and community education programs are necessary to decrease MRSA prevalence and minimize the public health risk posed by this pathogen.

Highlights

Staphylococcus aureus is part of the normal skin and nasal microbiota, and around 30% of the healthy adult population is colonized mainly in the nasopharyngeal cavity [1]
methicillin-resistant Staphylococcus aureus (MRSA) first emerged in the United Kingdom after methicillin was introduced in hospitals to combat penicillin-resistant S. aureus in 1961, and MRSA incidence has increased since that time [2]
In the early 2000s, infections arose in otherwise healthy community members and a distinction was made between hospital-acquired MRSA (HA-MRSA) and community-acquired MRSA (CA-MRSA) in Canada [3]

Summary

Introduction

Staphylococcus aureus is part of the normal skin and nasal microbiota, and around 30% of the healthy adult population is colonized mainly in the nasopharyngeal cavity [1]. While colonization is usually asymptomatic, symptomatic infection can occur if there is a breach in the mucosal barrier or skin [1]. MRSA first emerged in the United Kingdom after methicillin was introduced in hospitals to combat penicillin-resistant S. aureus in 1961, and MRSA incidence has increased since that time [2]. The first recorded outbreak of MRSA in Canada occurred in the early 1980s within a hospital setting [2]. In the early 2000s, infections arose in otherwise healthy community members and a distinction was made between hospital-acquired MRSA (HA-MRSA) and community-acquired MRSA (CA-MRSA) in Canada [3]. CA-MRSA strains can cause severe infections in otherwise healthy individuals. CA-MRSA strains display enhanced virulence, spreading more rapidly and causing more severe illness than HA-MRSA strains [4]. Unlike in other parts of the world, the majority of MRSA infections in Canada remain attributable to healthcare exposure [3]

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