Methicillin-Resistant Staphylococcus aureus among Clinical Isolates in Indonesia: A Systematic Review

Abstract

BACKGROUND: The high infection of methicillin-resistant Staphylococcus aureus (MRSA) accompanied by increased resistance to many groups of antibiotics is a major concern in the field of infection. This study aims to evaluate the prevalence of MRSA isolates and antimicrobial susceptibility to MRSA isolates in Indonesia. METHODS: We did searches in Pubmed, Proquest, DOAJ, GARUDA, and google scholar for studies published in 2006-2020. Study in Indonesian (Bahasa) and English with the keywords "methicillin-resistant Staphylococcus aureus", "MRSA" and "Indonesia". More than 30 S.aureus isolates derived from human samples were included. RESULTS: A total of 738 articles based on the search results, 13 studies were included in this systematic review. The prevalence of MRSA reported from all studies is 0.3%-52%. The study with the largest prevalence of MRSA was found in Jakarta. The susceptibility of vancomycin antibiotics to MRSA isolates is known to range from 87%-100%. Based on all studies, Linezolid, Tigecycline, Nitrofurantoin, and quinupristin/dalfopristin were reported to have 100% susceptibility. CONCLUSIONS: The prevalence of MRSA is still found high in one of the cities in Indonesia. Surveillance of antibiotic use, monitoring of antimicrobial susceptibility patterns, and antibiotic resistance control programs need to be optimized. MRSA screening is based on a rapid diagnosis when an inpatient admission is also necessary.

Hubungan Kualitas Penggunaan Antibiotik dengan Luaran Klinis Pasien Bakteremia yang Disebabkan Methicillin Resistant Staphylococcus aureus (MRSA)

“…Prevalensi kejadian MRSA di Malaysia meningkat menjadi 44,1% pada tahun 2007. Berdasarkan pengamatan sistematis yang dilakukan oleh Syahniar, et al (2020), prevalensi infeksi MRSA di Indonesia sekitar 0,3% -52% dengan prevalensi tertinggi ditemukan di Jakarta mencapai 47% dan prevalensi terendah dilaporkan di Semarang sebesar 0.3%. Lebih lanjut, data yang merujuk pada kasus MRSA di Aceh berdasarkan penelitian yang dilakukan oleh Zinatul (2019) pada Rumah Sakit Umum Daerah Dr. Zainoel Abidin (RSUDZA) Banda Aceh, dilaporkan sebanyak 133 isolat (51%) dari 259 isolat adalah kasus infeksi MRSA (6)(7)(8) .…”

“…Penelitian yang dilakukan oleh Khatib, et al (2016) menjelaskan bahwa bakteremia yang disebabkan oleh MRSA berhubungan erat dengan luaran hasil perawatan yang buruk dibandingkan bakteremia yang disebabkan bakteri MSSA. Pada penelitian tersebut dijelaskan bahwa penggunaan antibiotik yang tidak tepat pada kasus bakteremia yang disebabkan oleh bakteri MRSA memiliki luaran hasil perawatan berupa mortalitas sebesar 25,2% hingga 35% dengan rerata lama perawatan di rumah sakit (length of stay) selama 16 sampai 20 hari perawatan, tergantung pada jenis antibiotik yang dipilih (3)(4)(5)(6)(7)(8)(9) . Hamdy, et al (2017) juga melaporkan hasil penelitianya terhadap hasil perawatan pasien dengan bakteremia akibat MRSA, yang menyimpulkan bahwa hasil perawatan dengan pemberian antibiotik pada pasien bakteremia umumnya dapat dinilai setelah hari perawatan ke tujuh dan tetap dalam pemantauan hingga hari ke tiga puluh karena beresiko mengalami sequele atau kekambuhan setelah dosis antibiotik diturunkan (10) .…”

Nasal Carriage and Antimicrobial Susceptibility Pattern of Staphylococcus aureus among Breastfeeding Mothers and their Infants

“…2 The systematic review study that we have done has found the prevalence of MRSA 0.3%-52% from various clinical isolates in Indonesia. 5 The results of a meta-analysis study found that infants who were colonized with MRSA were approximately five times more likely to develop MRSA infection than infants who were not colonized. 4 In recent decades, the prevalence of infections caused by MRSA has increased among healthy people, especially children.…”

Knowledge and attitudes towards antibiotic resistance among health profession students in Indonesia

“…Increasing antimicrobial resistance reduces drug efficacy and makes treating patients complicated and expensive [7], which results in prolonged illness and increased mortality [8], [9]. The problem that often occurs is when patients do not comply with the rules of taking medication so that resistance occurs.…”