Background
Methods
Literature search strategy
Database | Search period | Search strategy |
---|---|---|
MEDLINE via PubMed EBSCOhost via Academic Search premier, Africa-Wide information and CINAHL | 1974 - August 2016 1982 - August 2016 | (Staphylococcus aureus OR S. aureus) AND (Mupirocin) AND (Algeria OR Angola OR Benin OR Botswana OR Burkina Faso OR “Burkina Faso” OR Burkina Fasso OR Upper Volta OR “Upper Volta” OR Burundi OR Cameroon OR Cape Verde OR “Cape Verde” OR Central African Republic OR Chad OR Comoros OR “Iles Comores” OR Iles Comores OR Comoro Islands OR “Comoro Islands” OR Congo OR Democratic Republic Congo OR “Democratic Republic of the Congo” OR Zaire OR Djibouti OR Egypt OR Equatorial Guinea OR “Equatorial Guinea” OR Eritrea OR Ethiopia OR Gabon OR Gambia OR Ghana OR Guinea OR Guinea Bissau OR “Guinea Bissau” OR Ivory Coast OR “Ivory Coast” OR Cote d’Ivoire OR “Cote d’Ivoire” OR Kenya OR Lesotho OR Liberia OR Libya OR Libia OR Jamahiriya OR Jamahiryia OR Madagascar OR Malawi OR Mali OR Mauritania OR Mauritius OR Ile Maurice OR “Ile Maurice” OR Morocco OR Mozambique OR Moçambique OR Namibia OR Niger OR Nigeria OR Rwanda OR Sao Tome OR “Sao Tome” OR Senegal OR Seychelles OR Sierra Leone OR “Sierra Leone” OR Somalia OR South Africa OR “South Africa” OR Sudan OR South Sudan OR “South Sudan” OR Swaziland OR Tanzania OR Tanganyika OR Zanzibar OR Togo OR Tunisia OR Uganda OR Western Sahara OR “Western Sahara” OR Zambia OR Zimbabwe OR Africa OR Africa* OR Southern Africa OR West Africa OR Western Africa OR Eastern Africa OR East Africa OR North Africa OR Northern Africa OR Central Africa OR Sub Saharan Africa OR Subsaharan Africa OR Sub-Saharan Africa) NOT (Guinea pig* OR “Guinea pig*” OR Aspergillus niger OR “Aspergillus niger” OR Europe* OR America* OR Asia*) |
ISI Web of Science | 1950 - August 2016 | |
Scopus from SciVerse | 1982 - August 2016 | (Staphylococcus aureus OR S. aureus) AND (Mupirocin) AND (Africa)a |
Google Scholar** | (Staphylococcus aureus OR S. aureus) AND (Mupirocin) AND (Name of each African country) Examples (Staphylococcus aureus OR S. aureus) AND (Mupirocin) AND (Algeria) (Staphylococcus aureus OR S. aureus) AND (Mupirocin) AND (Zimbabwe) |
Eligible article identification
Data extraction and analysis
Region | Country | Study Period | Setting | Sample | Method for testing resistance to mupirocin | Guideline (year of publication) | Published reports for detection of mupR S. aureus | Number of S. aureus isolates screened with mupirocin | Mupirocin resistant isolates | Reference | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Source | Type | Number (%) | Number MRSA (%) | Number LmupR/HmupR | Number mupA gene + LMupR/HmupR (Method) | |||||||||
North Africa | Algeria | 2005–2007 | C & H | Human | Pus, venous catheter, tracheal aspirate, punction fluid, blood, urine | Disk diffusion VITEK-2 | CLSI (NA) | – | 19 | 0 (0) | 0 (0) | – | – | [47] |
Egypt | 2005–2006 | C & H | Human | NA | Disk diffusion | NCCLS (2003) | – | 64 | 0 (0) | 0 (0) | – | – | [28] | |
Egypt | 2008–2009 | C & H | Human | Skin and soft tissue, post-operative wound swab | Disk diffusion | CLSI (2007) | – | 386 | 1 (0.3) | NA | NA | – | [29] | |
Egypt | 2007–2008 | C | Human | Pus, sputum, catheter, blood, urine, wound abscess | Broth dilution | CLSI (2005) | – | 21 | 0 (0) | 0 (0) | – | – | [58] | |
Egypt | 2010 | H | Human | Sputum, blood, catheter, traumatic wound, urine | E-test | – | Kresken et al., (2004) | 86 | 30 (34.9) | 30 (34.9) | 25/5 | 2/3 (PCR) | [30] | |
Egypt | 2012 | H | Human | Wound discharge, blood, body fluid aspirate, urine, faeces, sputum, nasal, throat, ear and genital swab | Disk diffusion Agar dilution | CLSI (2007) | – | 150 | 0 (0) | 0 (0) | – | – | [40] | |
Egypt | 2012–2013 | H | Human | Nasal swab | Disk diffusion | CLSI (2011) | – | 39 | 3 (7.7) | 3 (3.7) | NA | – | [31] | |
Egypt | 2013–2015 | H | Human | Pus & Wound swab | Agar dilution | CLSI (2011) | – | 73 | 13 (17.8) | 13 (17.8) | 5/8 | 0/6 (PCR) | [52] | |
Libya | NA | H | Human | Skin swab | Disk diffusion | NA | – | 40 | 0 (0) | NA | – | – | [61] | |
Libya | 2008–2009 | H | Human & Environment | NA | Disk diffusion | BSAC (2008) | – | 86 | 13 (15.1) | 13 (8.1) | NA | – | [56] | |
Libya | 2009 | H | Human | Nasal swab | Disk diffusion Agar dilution | BSAC (2008) | – | 109 | 5 (4.6) | 5 (4.6) | 4/1 | – | [57] | |
Morocco | 2008- | H | Human | Nasal swab | Disk diffusion | CA-SFM (2007) | – | 81 | 0 (0) | 0 (0) | – | – | [62] | |
Tunisia | 2008–2009 | C | Human | Nasal swab | Disk diffusion | CLSI (2008) | – | 55 | 0 (0) | 0 (0) | – | – | [41] | |
Tunisia | 2003–2005 | C | Human | Pus, blood, articular puncture, venous catheter | Phoenix Automated Microbiology System | CA-SFM (2006) | – | 64 | NA | NA | – | – | [59] | |
Tunisia | 2013 | H | Human | Wound abscess | Disk diffusion | CA-SFM (2013) | – | 8 | NA | NA | – | – | [60] | |
Tunisia | 2010 | C | Animal (Sheep) | Nasal swab | Disk diffusion | CLSI (2010) | – | 73 | 0 (0) | 0 (0) | – | – | [42] | |
Tunisia | 2010 | C | Animal (Donkeys) | Nasal swab | Disk diffusion | CLSI (2010) | – | 50 | 0 (0) | 0 (0) | – | – | [43] | |
West Africa | Ghana | 2011–2012 | H | Human | Nasal swab | Disk diffusion | EUCAST (2012) | – | 105 | 1 (0.9) | 0 (0) | 0/1 | – | [54] |
Ghana | 2011–2012 | C | Human | Nasal swab | Disk diffusion | EUCAST (2012) | – | 124 | 0 (0) | 0 (0) | – | – | [67] | |
Ghana | 2010–2013 | C & H | Human | NA | Broth microdilution | EUCAST (NA) | – | 30 | 4 (13.3) | 4 (13.3) | 4/0 | 0/0 (DNA microarray) | [55] | |
Ghana | 2012–2013 | C | Human | Nasal & Wound swab | VITEK-2 | EUCAST (NA) | – | 91 | 0 (0) | 0 (0) | – | – | [68] | |
Nigeria* | NA | NA | Human | NA | Disk diffusion | NA | – | 1 | 0 (0) | 0 (0) | – | – | [80] | |
Nigeria* | 2002–2004 | H | Human | Wound, blood, ear, eye, urine | Disk diffusion | – | Udo et al., (1999) | 200 | 1 (0.5) | 0 (0) | 0/1 | 0/1 (PCR) | [53] | |
Nigeria | 2006 | C | Human | Nasal swab | Disk diffusion | CLSI (2005) | – | 101 | 12 (11.9) | NA | NA | – | [44] | |
Nigeria | 2007 | H | Human | NA | Disk diffusion | CLSI (NA) | – | 96 | 0 (0) | 0 (0) | – | – | [48] | |
Nigeria* | NA | H | Human | Wound swab, blood, urine, endotracheal aspirate | Disk diffusion E-test | NCCLS (2003) | – | 1 | 1 | 0 (0) | 0/1 | 0/1 (PCR) | [45] | |
Nigeria | 2009 | H | Human | Wound, sputum, semen, nasal swab | Broth microdilution | DIN 58940 (2004) | – | 68 | 0 (0) | 0 (0) | – | – | [63] | |
Nigeria | 2010 | H | Human | NA | VITEK-2 | – | – | 51 | 0 (0) | 0 (0) | – | – | [64] | |
Nigeria | 2009–2011 | H | Human | Aspirate, blood, ear, eye, vaginal discharge, sputum, wounds, urine, nasal swab | Disk diffusion | CLSI (NA) | – | 62 | 0 (0) | 0 (0) | – | – | [49] | |
Nigeria | 2010–2011 | H | Human | NA | VITEK-2 | EUCAST (NA) | – | 290 | 0 (0) | 0 (0) | – | – | [65] | |
Nigeria | 2008–2010 | C | Animal (Bats) | Faecal swab | Disk diffusion | – | Udo et al., (1999) | 107 | 0 (0) | 0 (0) | – | – | [66] | |
Nigeria | 2006–2007 | C & H | Animal (Bovine) & (Ovine) | Nasal & skin swab | Disk diffusion | – | Udo et al., (1999) | 173 | 0 (0) | 0 (0) | – | – | [35] | |
Nigeria | 2012 | C | Human Animal | Nasal swab Milk | Disk diffusion | CLSI (2006) | – | 10 Humans 77 Animals | 33 (37.9) | NA | 0/33 | – | [36] | |
Central Africa | Gabon | 2009 | C & H | Human | Nasal, axillae, inguinal swab | VITEK-2 | – | – | 5 | 0 (0) | 0 (0) | – | – | [69] |
São Tomé & Príncipe | 2010–2012 | H | Human | Nasal swab | Disk diffusion | BSAC (NA) | – | 55 | 0 (0) | 0 (0) | – | – | [70] | |
East Africa | Ethiopia | NA | H & R | Cockroach | Cockroach Body surface/Gut | Disk diffusion | – | Jorgenson et al., (1999) | 17 | 17 (100) | NA | NA | – | [37] |
Kenya | 2011 | H | Human | Nasal and axillary skin swab | VITEK-2 | CLSI (2012) | – | 86 | 0 (0) | 0 (0) | – | – | [71] | |
Kenya | 2011–2013 | H | Human | Pus, blood, urine | VITEK-2 | CLSI (2010) | – | 731 | 0 (0) | 0 (0) | – | – | [72] | |
Kenya | NA | C | Animal (Camel) | Raw camel milk | Disk diffusion Broth microdilution | CLSI (2008) | – | 47 | 0 (0) | 0 (0) | – | – | [38] | |
South Africa | South Africa | 1996 | H | Human | Wound, urine, skin and blood | Disk diffusion | NCCLS (2000) | – | 236 | 5 (2.1) | NA | NA | – | [46] |
South Africa** | 2001–2003 | H | Human | Wound, sputum, blood | Disk diffusion | – | Udo et al., (1999) | 227 | 16 (7.0) | 15 (6.6) | 14/2 | 0/2 (PCR) | [50] | |
South Africa | 2005–2006 | H | Human | Blood, pus & skin wound, cerebrospinal fluid | Disk diffusion E-test | – | Udo et al., (2006) | 248 | 123 (49.6) | 123 (49.6) | 117/6 | – | [32] | |
South Africa** | NA | H | Human | Wound swab, blood, urine, endotracheal aspirate | Disk diffusion E-test | NCCLS (2003) | – | 16 | 16 (100) | 14 (87.5) | 14/2 | 0/2 (PCR) | [45] | |
South Africa | 2013 | H | Human | Tissue, blood, cerebrospinal fluid, wound swab | Disk diffusion VITEK-2 | CLSI (2012) | – | 997 | 277 (27.8) | NA | 43/234 | 0/5 (Real time PCR) | [33] | |
South Africa | 2010–2012 | H | Human | Blood | Microscan (MIC Panel Type 33) | CLSI (2015) | – | 2709 | 236 (8.7) | 202 (7.5) | NA | – | [51] | |
South Africa | 2009–2010 | H | Human & Environment | Nasal & hand swab, dialysate fluid, surface swab, air samples | VITEK-2 | – | – | 13 | 4 (30.8) | 4 (30.8) | 0/4 | – | [34] |
Results
Eligible studies from electronic database search
Screening and identification of mupR S. aureus in Africa
Mupirocin resistance | Country | Source | Number positive/Total tested (%) | Phenotypic | Molecular | Guidelines or reports | Reference | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Agar Dilution | Broth microdilution | Disk diffusion | E-test | Microscan system | VITEK | PCR | Micro array | BSAC | CLSI | EUCAST | Other reports | |||||
MupA-positive S. aureus | Egypt | Human | 5/86 (5.8) | – | – | – | √ | – | – | √ | – | – | – | – | √a | [30] |
Egypt | Human | 6/73 (8.2) | √ | – | – | – | – | – | √ | – | – | √ | – | – | [52] | |
Nigeria | Human | 1/200 (0.5) | – | – | √ | – | – | – | √ | – | – | – | – | √b | [53] | |
South Africa | Human | 2/227 (0.9) | – | – | √ | – | – | – | √ | – | – | – | – | √b | [50] | |
South Africa | Human | NA | – | – | √ | – | – | √ | √ | – | – | √ | – | – | [33] | |
LmupR S. aureus | Egypt | Human | 25/86 (29.1) | – | – | – | √ | – | – | √ | – | – | – | – | √a | [30] |
Egypt | Human | 5/73 (6.8) | √ | – | – | – | – | – | √ | – | – | √ | – | – | [52] | |
Ghana | Human | 4/30 (13.3) | – | √ | – | – | – | – | – | √ | – | – | √ | – | [55] | |
Libya | Human | 4/109 (3.7) | √ | – | √ | – | – | – | – | – | √ | – | – | – | [57] | |
South Africa | Human | 14/227 (6.2) | – | – | √ | – | – | – | – | – | – | – | – | √b | [50] | |
South Africa | Human | 117/248 (47.2) | – | – | √ | √ | – | – | – | – | – | – | – | √c | [32] | |
South Africa | Human | 43/997 (4.3) | – | – | √ | – | – | √ | – | – | – | √ | – | – | [33] | |
South Africa | Human & Environment | 4/13 (30.8) | – | – | – | – | – | √ | – | – | – | – | – | – | [34] | |
HmupR S. aureus | Egypt | Human | 5/86 (5.8) | – | – | – | √ | – | – | √ | – | – | – | – | √a | [30] |
Egypt | Human | 8/73 (11) | √ | – | – | – | – | – | √ | – | – | √ | – | – | [52] | |
Ghana | Human | 1/105 (1.0) | – | – | √ | – | – | – | – | – | – | – | √ | – | [54] | |
Libya | Human | 1/109 (0.9) | √ | – | √ | – | – | – | – | – | √ | – | – | – | [57] | |
Nigeria | Human | 1/200 (0.5) | – | – | √ | – | – | – | √ | – | – | – | – | √b | [53] | |
Nigeria | Human | 12/101 (11.9) | – | – | √ | – | – | – | – | – | – | √ | – | – | [44] | |
Nigeria | Human & Animal | 33/87 (37.9) | – | – | √ | – | – | – | – | – | – | √ | – | – | [36] | |
South Africa | Human | 2/227 (0.9) | – | – | √ | – | – | – | √ | – | – | – | – | √b | [50] | |
South Africa | Human | 6/248 (2.4) | – | – | √ | √ | – | – | – | – | – | – | – | √c | [32] | |
South Africa | Human | 234/997 (23.5) | – | – | √ | – | – | √ | – | – | – | √ | – | – | [33] | |
mupR-MRSA | Egypt | Human | 30/86 (34.9) | – | – | – | √ | – | – | √ | – | – | – | – | √a | [30] |
Egypt | Human | 3/39 (7.7) | – | – | √ | – | – | – | – | – | – | √ | – | – | [31] | |
Egypt | Human | 13/73 (17.8) | √ | – | – | – | – | – | √ | – | – | √ | – | – | [52] | |
Ghana | Human | 4/30 (13.3) | – | √ | – | – | – | – | – | √ | – | – | √ | – | [55] | |
Libya | Human | 13/86 (15.1) | – | – | √ | – | – | – | – | – | √ | – | – | – | [56] | |
Libya | Human | 5/109 (4.6) | √ | – | √ | – | – | – | – | – | √ | – | – | – | [57] | |
Nigeria | Human & Animal | 33/87 (37.9) | – | – | √ | – | – | – | – | – | – | √ | – | – | [36] | |
South Africa | Human | 15/227 (6.6) | – | – | √ | – | – | – | √ | – | – | – | – | √b | [50] | |
South Africa | Human | 123/248 (49.6) | – | – | √ | √ | – | – | – | – | – | – | – | √c | [32] | |
South Africa | Human | 202/2709 (7.5) | – | – | – | – | √ | – | – | – | – | √ | √ | – | [51] | |
South Africa | Human & Environment | 4/13 (30.8) | – | – | – | – | – | √ | – | – | – | – | – | – | [34] |