Methicillin-resistant Staphylococcus aureus in Nepal: A systematic review and meta-analysis

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) poses a global health challenge, particularly in developing nations like Nepal.
• Low healthcare standards and antibiotic misuse contribute to the prevalence of MRSA in Nepalese hospitals.
• MRSA strains are frequently detected but often underreported in Nepal.

Purpose of the Study:

• To systematically review and analyze the prevalence of MRSA in Nepal.
• To evaluate the antimicrobial susceptibility patterns of MRSA strains in the country.
• To provide a national-level understanding of the MRSA burden.

Main Methods:

• A systematic review and meta-analysis of studies published between 2008 and 2020.
• Searches conducted across major databases including PubMed, EMBASE, Cochrane CENTRAL, Google Scholar, and Nepalese databases.
• Quantitative analysis of 26 selected original articles using specialized meta-analysis software.

Main Results:

• The pooled prevalence of MRSA infections was 38.2% (95% CI, 31.4%-45.2%) among 5951 S. aureus isolates.
• Significant heterogeneity was observed (I² = 96.7%), with no evidence of publication bias.
• MRSA strains exhibited high resistance to beta-lactam antibiotics, with high susceptibility to vancomycin (98.0%) and chloramphenicol (91.0%).

Conclusions:

• The overall burden of MRSA in Nepal is substantial and shows an increasing trend.
• Effective control strategies require sound legislation and defined antibiotic policies.
• Implementing control interventions is crucial for managing MRSA and broader antimicrobial resistance.