Clinical and Diagnostic Significance of Methicillin-resistant Staphylococcus aureus Infection in Bangladesh: A Systematic Review

Abstract

Background: Accurate diagnosis of Methicillin-resistant Staphylococcus aureus (MRSA) is essential for the clinician. In Bangladesh MRSA creates a great problem for the treatment of infection. Objective: The purpose of the present study was to observe the clinical and diagnostic significance of MRSA infection in Bangladesh. Design: Systematic review of published articles in Bangladesh. Data Sources: PubMed (Medline), Embase, Scopus, Web of Science, the Cochrane Library, and the World Health Organization (WHO) Regional Databases (African, eastern Mediterranean, Latin American and Caribbean, western Pacific, and southeast Asian regions) as well as Google Scholar, Banglajol, Asiajol. Review Methods: The search was restricted to full articles published from January 2000 (publication date of the first study identified by the research) to December 2013. Studies were excluded that did not provide appropriate data on the prevalence of MRSA. Only English language was applied. Result: A total number of 125 studies were identified during systematic review which were relevant to the present research question and among these only 14 studies were met the criteria for analysis. The level of evidence and freedom from bias of these studies were generally low. MRSA was diagnosed phenotypic in most of the articles. Majority were isolated from skin wound. The isolation rate of MRSA among all culture isolates ranged from 4.8-78.7%. From all studies diagnosis of MRSA infection was done from hospital setting; however, only two studies had been reported from community settings though the CDC definition was not followed in either study. Conclusion: Significance of methicillin-resistant Staphylococcus aureus infection in Bangladesh is very high leading to a huge clinical as well as laboratory burden in the heath care facilities as well as in the community settings of Bangladesh.