Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) in Latin America

Abstract

After the first reports of the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the 1970s, numerous measures intended to prevent its transmission were initiated in hospitals. However, in most cases, large-scale measures failed to be implemented and the transmission of MRSA has since led to a global pandemic. Presently, doubts still remain about the best approach to prevent and control MRSA and more often than not, control measures are not implemented. Therefore, we review here the current situation in Latin America with respect to existing policies for control of MRSA, and evaluate the evidence for control measures in hospitals and the community. We look at the risk factors for infection and transmission of MRSA between hospital patients and within specific populations in the community, and at the effect of antibiotic usage on the spread of MRSA in these settings. Finally, we summarize recommendations for the prevention and control of MRSA, which can be applied to the Latin American hospital environment and community setting.

Prevalence of resistance phenotypes in Staphylococcus aureus and coagulase-negative isolates of venous ulcers of primary healthcare patients

“…Skin and soft tissue infections, alone, are risk factors for the transmission of MDROs S. aureus and coagulase-negative Staphylococcus in the population 6 . These infections account for most infections by MRSA in the community 28 , which are usually treated in outpatient clinic settings.…”

“…The possibility of multi-drug resistant agents (MDROs) is also a problem. Studies in different countries or regions, point to a growing prevalence of these pathogens [5][6][7][8] .…”

Detection of Oxacillin (Methicillin)-resistant Staphylococcus aureus Isolated from a Tertiary-care Hospital, Georgetown, Guyana

“…This low frequency of isolation may be due solely, or in part, to existing infection control measures and practices that were implemented for these units. This finding further highlights that implementation of infection control measures can help minimize the spread of MRSA and reduce carriage and infection rates in hospitals where MRSA is endemic [26].…”

“…Furthermore, given that so many isolates expressing high level oxacillin resistance had the same MIC values; it is worth considering that these isolates may have been clonally related. According to Alvarez et al [26], dissemination of S. aureus or its antibiotic-resistant forms in hospitals is most often clonal, that is, very few clones are circulating, commonly, in each hospital at the same time.…”

Avaliação da efetividade da aplicação nasal de sulfadiazina de prata para descolonização de pacientes portadores de <i>Staphylococcus aureus</i> resistentes à meticilina em ambiente hospitalar

“…Vários estudos apontam aumento da resistência à mupirocina em várias instituições que utilizam a mupirocina para a descolonização de MRSA, e também demonstram que a resistência a este antimicrobiano tem sido um fator associado a falha na descolonização de MRSA (SIMOR et al, 2007;AMMERLAAN et al, 2009;ALVAREZ;LABARCA;SALLES, 2010;SIMOR, 2011;BECKER et al, 2014;CALFEE et al, 2014). Os avanços alcançados na área da assistência médica hospitalar tornam possíveis hoje salvar muitas pessoas que anteriormente morriam em decorrência de suas doenças.…”