The prevalence and characterization of the epidemic ST239-MRSA clone

Abstract

Background: ST239-methicillin-resistant Staphylococcus aureus (MRSA) is possibly the true oldest pandemic methicillin-resistant strain that is still often isolated in different parts of the world. Recently, there have been increasing reports of ST239-MRSA in Iran. Therefore, the present study aimed to analyze the published literature for estimating the prevalence and microbiological characteristics of ST239-MRSA. Methods: A systematic review was performed through searching various electronic bibliographic databases including Web of Science, PubMed, Scopus, Embase, and Google Scholar from January 2000 to December 2020. Afterward, 11 articles meeting the inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. Results: In these surveys, the pooled prevalence of ST239-MRSA among Iranian patients was 39.3% (95% confidence interval [CI]: 25.8–54.6%). According to subgroup analysis patients in Ahvaz (South of Iran) experienced the highest prevalence of ST239-MRSA isolates with a pooled prevalence of 77.5% (95% CI: 66.3–85.7). This study showed that a remarkable proportion of ST239-MRSA isolates were toxic shock syndrome toxin 1 producer with 16.7% (95% CI: 9.5–27.6), while, the occurrence of Panton-Valentine leukocidin-positive ST239-MRSA isolates was low 1.3% (95% CI: 0.6–2.8). Conclusion: Our results showed the prevalence of the epidemic ST239-MRSA clone among Iranian patients. Because of the aggressive characterization of ST239-MRSA, circulation this clone within the country could be a predictor of treatment failure and higher morbidity and mortality among inpatients. The wide dissemination of ST239-MRSA emphasizes the need for restricted infection prevention and control and optimizing antibiotic stewardship.