Mitevska Elena, Wong Britney, Surewaard Bas G J, Jenne Craig N
Immunology and Infectious Diseases, Department of Microbiology, University of Calgary, Calgary, AB T2N1N4, Canada.
Snyder Institute for Chronic Diseases, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB T2N1N4, Canada.
Pathogens. 2021 Mar 25;10(4):393. doi: 10.3390/pathogens10040393.
Methicillin-resistant (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.
耐甲氧西林金黄色葡萄球菌（MRSA）在引入甲氧西林以对抗青霉素耐药性后首次出现，自20世纪80年代初首次爆发MRSA疫情以来，其在加拿大的流行率一直在上升。我们回顾了加拿大不同时期以及全国不同人群中MRSA流行情况的现有文献。在20世纪90年代和21世纪，MRSA流行率稳步上升，在加拿大仍然是一个公共卫生问题，尤其是在农村、偏远和原住民社区等弱势群体中。还报告了MRSA感染的抗生素耐药模式和风险因素。所有研究均报告对甲氧苄啶 - 磺胺甲恶唑具有高敏感性（>85%），未报告对万古霉素、利奈唑胺或利福平有显著耐药性。虽然MRSA对几种抗生素仍具有敏感性，但对其他药物的高耐药率且有时存在变异性，凸显了抗菌药物管理的重要性。还报告了与感染控制措施、低社会经济地位和个人人口统计学特征相关的高MRSA感染率的风险因素。需要进行额外的监测、感染控制措施、加强抗菌药物管理以及社区教育项目，以降低MRSA流行率，并将这种病原体带来的公共卫生风险降至最低。
