Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis
| dc.contributor.author | Shittu, Adebayo O | |
| dc.contributor.author | Kaba, Mamadou | |
| dc.contributor.author | Abdulgader, Shima M | |
| dc.contributor.author | Ajao, Yewande O | |
| dc.contributor.author | Abiola, Mujibat O | |
| dc.contributor.author | Olatimehin, Ayodele O | |
| dc.date.accessioned | 2018-09-10T09:49:53Z | |
| dc.date.available | 2018-09-10T09:49:53Z | |
| dc.date.issued | 2018-08-15 | |
| dc.date.updated | 2018-08-19T03:21:54Z | |
| dc.description.abstract | Background Mupirocin is widely used for nasal decolonization of Staphylococcus aureus to prevent subsequent staphylococcal infection in patients and healthcare personnel. However, the prolonged and unrestricted use has led to the emergence of mupirocin-resistant (mupR) S. aureus. The aim of this systematic review was to investigate the prevalence, phenotypic and molecular characteristics, and geographic spread of mupR S. aureus in Africa. Methods We examined five electronic databases (EBSCOhost, Google Scholar, ISI Web of Science, MEDLINE, and Scopus) for relevant English articles on screening for mupR S. aureus from various samples in Africa. In addition, we performed random effects meta-analysis of proportions to determine the pooled prevalence of mupR S. aureus in Africa. The search was conducted until 3 August 2016. Results We identified 43 eligible studies of which 11 (26%) were obtained only through Google Scholar. Most of the eligible studies (28/43; 65%) were conducted in Nigeria (10/43; 23%), Egypt (7/43; 16%), South Africa (6/43; 14%) and Tunisia (5/43; 12%). Overall, screening for mupR S. aureus was described in only 12 of 54 (22%) African countries. The disk diffusion method was the widely used technique (67%; 29/43) for the detection of mupR S. aureus in Africa. The mupA-positive S. aureus isolates were identified in five studies conducted in Egypt (n = 2), South Africa (n = 2), and Nigeria (n = 1). Low-level resistance (LmupR) and high-level resistance (HmupR) were both reported in six human studies from South Africa (n = 3), Egypt (n = 2) and Libya (n = 1). Data on mupR-MRSA was available in 11 studies from five countries, including Egypt, Ghana, Libya, Nigeria and South Africa. The pooled prevalence (based on 11 human studies) of mupR S. aureus in Africa was 14% (95% CI =6.8 to 23.2%). The proportion of mupA-positive S. aureus in Africa ranged between 0.5 and 8%. Furthermore, the frequency of S. aureus isolates that exhibited LmupR, HmupR and mupR-MRSA in Africa were 4 and 47%, 0.5 and 38%, 5 and 50%, respectively. Conclusions The prevalence of mupR S. aureus in Africa (14%) is worrisome and there is a need for data on administration and use of mupirocin. The disk diffusion method which is widely utilized in Africa could be an important method for the screening and identification of mupR S. aureus. Moreover, we advocate for surveillance studies with appropriate guidelines for screening mupR S. aureus in Africa. | |
| dc.identifier.apacitation | Shittu, A. O., Kaba, M., Abdulgader, S. M., Ajao, Y. O., Abiola, M. O., & Olatimehin, A. O. (2018). Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis. <i>Antimicrobial Resistance and Infection Control</i>, http://hdl.handle.net/11427/28452 | en_ZA |
| dc.identifier.chicagocitation | Shittu, Adebayo O, Mamadou Kaba, Shima M Abdulgader, Yewande O Ajao, Mujibat O Abiola, and Ayodele O Olatimehin "Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis." <i>Antimicrobial Resistance and Infection Control</i> (2018) http://hdl.handle.net/11427/28452 | en_ZA |
| dc.identifier.citation | Antimicrobial Resistance & Infection Control. 2018 Aug 15;7(1):101 | |
| dc.identifier.ris | TY - Journal Article AU - Shittu, Adebayo O AU - Kaba, Mamadou AU - Abdulgader, Shima M AU - Ajao, Yewande O AU - Abiola, Mujibat O AU - Olatimehin, Ayodele O AB - Background Mupirocin is widely used for nasal decolonization of Staphylococcus aureus to prevent subsequent staphylococcal infection in patients and healthcare personnel. However, the prolonged and unrestricted use has led to the emergence of mupirocin-resistant (mupR) S. aureus. The aim of this systematic review was to investigate the prevalence, phenotypic and molecular characteristics, and geographic spread of mupR S. aureus in Africa. Methods We examined five electronic databases (EBSCOhost, Google Scholar, ISI Web of Science, MEDLINE, and Scopus) for relevant English articles on screening for mupR S. aureus from various samples in Africa. In addition, we performed random effects meta-analysis of proportions to determine the pooled prevalence of mupR S. aureus in Africa. The search was conducted until 3 August 2016. Results We identified 43 eligible studies of which 11 (26%) were obtained only through Google Scholar. Most of the eligible studies (28/43; 65%) were conducted in Nigeria (10/43; 23%), Egypt (7/43; 16%), South Africa (6/43; 14%) and Tunisia (5/43; 12%). Overall, screening for mupR S. aureus was described in only 12 of 54 (22%) African countries. The disk diffusion method was the widely used technique (67%; 29/43) for the detection of mupR S. aureus in Africa. The mupA-positive S. aureus isolates were identified in five studies conducted in Egypt (n = 2), South Africa (n = 2), and Nigeria (n = 1). Low-level resistance (LmupR) and high-level resistance (HmupR) were both reported in six human studies from South Africa (n = 3), Egypt (n = 2) and Libya (n = 1). Data on mupR-MRSA was available in 11 studies from five countries, including Egypt, Ghana, Libya, Nigeria and South Africa. The pooled prevalence (based on 11 human studies) of mupR S. aureus in Africa was 14% (95% CI =6.8 to 23.2%). The proportion of mupA-positive S. aureus in Africa ranged between 0.5 and 8%. Furthermore, the frequency of S. aureus isolates that exhibited LmupR, HmupR and mupR-MRSA in Africa were 4 and 47%, 0.5 and 38%, 5 and 50%, respectively. Conclusions The prevalence of mupR S. aureus in Africa (14%) is worrisome and there is a need for data on administration and use of mupirocin. The disk diffusion method which is widely utilized in Africa could be an important method for the screening and identification of mupR S. aureus. Moreover, we advocate for surveillance studies with appropriate guidelines for screening mupR S. aureus in Africa. DA - 2018-08-15 DB - OpenUCT DP - University of Cape Town J1 - Antimicrobial Resistance and Infection Control LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis TI - Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis UR - http://hdl.handle.net/11427/28452 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s13756-018-0382-5 | |
| dc.identifier.uri | http://hdl.handle.net/11427/28452 | |
| dc.identifier.vancouvercitation | Shittu AO, Kaba M, Abdulgader SM, Ajao YO, Abiola MO, Olatimehin AO. Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis. Antimicrobial Resistance and Infection Control. 2018; http://hdl.handle.net/11427/28452. | en_ZA |
| dc.language.iso | en | |
| dc.publisher | BioMed Central | |
| dc.publisher.department | Department of Pathology | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights.holder | The Author(s). | |
| dc.source | Antimicrobial Resistance and Infection Control | |
| dc.source.uri | https://aricjournal.biomedcentral.com/ | |
| dc.subject.other | Africa | |
| dc.subject.other | Prevalence | |
| dc.subject.other | Meta-analysis | |
| dc.subject.other | Mupirocin | |
| dc.subject.other | Staphylococcus aureus | |
| dc.subject.other | Systematic review | |
| dc.title | Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis | |
| dc.type | Journal Article | |
| uct.type.filetype | Text | |
| uct.type.filetype | Image |