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Research Project: Alternatives to Antibiotics and Genomics of Antimicrobial Resistance to Control Foodborne Pathogens in Poultry

Location: Poultry Microbiological Safety and Processing Research Unit

Title: Epidemiology of Staphylococcus aureus non-susceptible to vancomycin in South Asia

Author
item EJAZ, MOHAMMAD - Government Postgraduate College Mandian Abbottabad
item SYED, MUHAMMAD ALI - University Of Haripur
item Jackson, Charlene
item SHARIF, MEHMOONA - Qauid-I-azam University
item FARYAL, RANI - Qauid-I-azam University

Submitted to: Antibiotics
Publication Type: Review Article
Publication Acceptance Date: 5/23/2023
Publication Date: 5/27/2023
Citation: Ejaz, M., Syed, M., Jackson, C.R., Sharif, M., Faryal, R. 2023. Epidemiology of Staphylococcus aureus non-susceptible to vancomycin in South Asia. Antibiotics. 12(6). Article 12060972. https://doi.org/10.3390/antibiotics12060972.
DOI: https://doi.org/10.3390/antibiotics12060972

Interpretive Summary: Excessive use and misuse of vancomycin are major causes of vancomycin resistance among Staphylococcus aureus strains especially in low- and middle-income countries with poor healthcare infrastructures such as in South Asia. To begin to understand the mechanism of vancomycin resistance, its emergence in S. aureus, and the molecular epidemiology of non-susceptible S. aureus to vancomycin in the South Asian region, a comprehensive literature search was performed. PubMed, Google Scholar, and Web of Science databases were searched for original research publications from 1997 to March 2023 using terms relevant to S. aureus and vancomycin. Less than 40 publications were found relevant to the epidemiology of non-susceptible vancomycin S. aureus in South Asia showing the lack of reporting in the region, especially in India and Pakistan where the antibiotic resistance burden is alarmingly high. Data for the resource-constrained countries of Southeast Asia and South Asia is significantly constrained by either incomplete or completely unavailable published studies. This information is useful to epidemiologists for determining factors contributing to antibiotic resistance.

Technical Abstract: Staphylococcus aureus is one of the ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) pathogens among which multidrug resistance has emerged. Resistance to methicillin resulted in clinicians using the antibiotic of last resort, vancomycin, to treat infections caused by methicillin-resistant S. aureus (MRSA). However, excessive use and misuse of vancomycin are major causes of resistance among S. aureus strains. South Asia encompasses ~25% of the world’s population and countries in South Asia are often characterized as low- and middle-income countries with poor healthcare infrastructures that may contribute to the emergence of antibiotic resistance. Here, we briefly highlight the mechanism of vancomycin resistance, its emergence in S. aureus, and the molecular epidemiology of non-susceptibility S. aureus to vancomycin in the South Asian region.