Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon.
PLoS One. 2023 Dec 22;18(12):e0296267. doi: 10.1371/journal.pone.0296267. eCollection 2023.
The emergence of methicillin-resistant Staphylococcus aureus (MRSA) has increased and poses a significant threat to human and animal health in Cameroon and the world at large. MRSA strains have infiltrated various settings, including hospitals, communities, and livestock, contributing to increased morbidity, treatment costs, and mortality. This evidence synthesis aims to understand MRSA prevalence, resistance patterns, and genetic characterization in Cameroon.
The methodology was consistent with the PRISMA 2020 guidelines. Studies of any design containing scientific data on MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon were eligible for inclusion, with no restrictions on language or publication date. The search involved a comprehensive search strategy in several databases including Medline, Embase, Global Health, Web of Science, African Index Medicus, and African Journal Online. The risk of bias in the included studies was assessed using the Hoy et al tool, and the results were synthesized and presented in narrative synthesis and/or tables and graphs.
The systematic review analyzed 24 studies, mostly conducted after 2010, in various settings in Cameroon. The studies, characterized by moderate to low bias, revealed a wide prevalence of MRSA ranging from 1.9% to 46.8%, with considerable variation based on demographic and environmental factors. Animal (0.2%), food (3.2% to 15.4%), and environmental samples (0.0% to 34.6%) also showed a varied prevalence of MRSA. The genetic diversity of MRSA was heterogeneous, with different virulence gene profiles and clonal lineages identified in various populations and sample types. Antimicrobial resistance rates showed great variability in the different regions of Cameroon, with notable antibiotic resistance recorded for the beta-lactam, fluoroquinolone, glycopeptide, lincosamide, and macrolide families.
This study highlights the significant variability in MRSA prevalence, genetic diversity, and antimicrobial resistance patterns in Cameroon, and emphasizes the pressing need for comprehensive antimicrobial stewardship strategies in the country.
耐甲氧西林金黄色葡萄球菌（MRSA）的出现有所增加，对喀麦隆乃至全球的人类和动物健康构成了重大威胁。MRSA 菌株已经渗透到各种环境中，包括医院、社区和牲畜，导致发病率、治疗成本和死亡率上升。本证据综合分析旨在了解 MRSA 在喀麦隆的流行率、耐药模式和遗传特征。
该方法符合 PRISMA 2020 指南。纳入了任何设计的研究，这些研究包含了关于 MRSA 在喀麦隆的流行率、遗传多样性和抗生素耐药模式的科学数据，对语言和出版日期没有限制。检索包括在几个数据库中进行了全面的检索策略，包括 Medline、Embase、全球健康、Web of Science、非洲医学索引和非洲在线期刊。使用 Hoy 等人的工具评估纳入研究的偏倚风险，并以叙述性综合或表格和图表的形式综合和呈现结果。
系统综述分析了 24 项研究，这些研究主要是在喀麦隆的不同环境中进行的，时间大多在 2010 年后。这些研究的偏倚程度为中度至低度，显示出 MRSA 的广泛流行率范围从 1.9%到 46.8%，受人口统计学和环境因素的影响差异很大。动物（0.2%）、食品（3.2%至 15.4%）和环境样本（0.0%至 34.6%）也显示出 MRSA 的不同流行率。MRSA 的遗传多样性是异质的，不同的毒力基因谱和克隆谱系在不同的人群和样本类型中被识别。不同地区的抗生素耐药率在喀麦隆有很大的差异，β-内酰胺类、氟喹诺酮类、糖肽类、林可酰胺类和大环内酯类抗生素的耐药性尤为显著。
本研究强调了 MRSA 在喀麦隆的流行率、遗传多样性和抗生素耐药模式的显著变化，强调了在该国实施全面的抗生素管理策略的迫切需要。
