Epidemiology of Methicillin Resistant Staphylococcus Aureus in Arab Countries of the Middle East and North African Region

Abstract

Available data suggests a high burden of methicillin-resistant staphylococcus aureus (MRSA) in Arab countries of the Middle East and North Africa (MENA). To review the MRSA prevalence and molecular epidemiology in this region, we used PubMed search engine to identify relative articles published from January 2005 to December 2019. Great heterogeneity in reported rates was expectedly seen. Nasal MRSA colonization ranged from 0-32% in healthy volunteers but 4-73% in healthcare workers. Infective MRSA rates ranged between 6%-66% in Saudi Arabia, 12%-29% in United Arab of Emirates, 13%-21% in Qatar, 14%-37% in Oman, 20%-72% in Lebanon, 56% in Gaza, 32%-68% in Jordan, 34%-88% in Iraq and Iraqi Kurdistan, 47%-77% in Egypt, 19-86% in Algeria, and 18-40% in Tunisia. In the GCC, [PVL-] ST239-III, [PVL+] ST80-IV, [PVL+] ST30-IV, [PVL-] ST22-IV and its [PVL+] and [tst1+] variants, [PVL-] CC6-IV, [PVL-] CC5-IV, and [PVL-] ST5-II had a significant presence. In the Levant region, [PVL+] ST80-IV, [PVL+] ST30-IV, [PVL-] ST239-III, [PVL-] ST22-IV were prevalent in Lebanon, Jordan, and Gaza; [PVL-] ST22-IVa-t223 (“Gaza strain”) was prevalent in Gaza and Jordan; USA300, and USA800 were prevalent in Iraq. In North Africa, [PVL+] ST80-IV and [PVL-] ST239-III was commonly reported in Egypt, Algeria, and Tunisia. Finally, significant antimicrobial resistance was seen in the region with variation in patterns depending on location and clonal type. For a more accurate assessment of MRSA epidemiology and burden, the Arab countries need to implement national surveillance systems.

Detection of Mupirocin Resistance in Methicillin- Resistant Staphylococcus aureus Isolates in an Egyptian Hospital

“…In the current study, mupirocin resistant MRSA strains were also resistant to tetracycline, chloramphenicol, gentamycin, ciprofloxacin, and trimethoprim-sulfamethoxazole compared to mupirocinsusceptible ones, This could be explained by the fact that the plasmid-encoded mupA gene mediating highlevel mupirocin resistance in S. aureus can be found on conjugative plasmids that carry numerous antimicrobial resistance determinants 23 .…”

Microbiological Profile and Drug Resistance Analysis of Postoperative Infections following Orthopedic Surgery: A 5-Year Retrospective Review

“…Advances in Orthopedics e incidence of orthopedic-related postoperative infections in the literature ranges from 2.5% to 41.9% [11,[16][17][18][19][20][21][22][23]. Comparable rates were found in developing countries, such that in a study conducted on 3096 orthopedic patients at a university hospital in Saudi Arabia, the incidence was found to be 2.55% [24]. A higher rate was found in another study conducted at a tertiary hospital in Oman to evaluate the surgical site infection following different orthopedic procedures showing a rate of 8.57% [11].…”

“…Arab countries face a significant MRSA burden, as MRSA rates among S . aureus infections range from 9% to 69%, with Jordan having one of the highest rates (37%) [ 24 ]. Based on our results, MRSA was the most common infective organism, accounting alone for 30.4% of cases.…”

Methicillin-Resistant Staphylococcus aureus (MRSA) and Other Methicillin-Resistant Staphylococci and Mammaliicoccus (MRNaS) Associated with Animals and Food Products in Arab Countries: A Review

“…While there are data on S. aureus and MRSA on camel-derived food products [ 114 , 115 , 116 ], there is only one study that confirms the presence of methicillin resistance in S. aureus in these animals [ 61 ]. The MRSA isolates belonged to the European community-associated CA-MRSA CC80, which could indicate that the origin of these strains is human as it is one of the most reported CCs in humans in the Arab world [ 117 ]. Further studies are necessary to determine the extent and potential zoonotic aspect of MRSA in camelids.…”