Resistance Treads and Treatment with Vancomycin for Hospital-Acquired Methicillin-Resistant Staphylococcus aureus(HA-MRSA) Infections in African Hospitals: A Systematic Review (2015–2025

Authors

  • Shahd Alfaki UMST Author

DOI:

https://doi.org/10.66383/tzh8kn50

Keywords:

Africa, Antimicrobial Stewardship, Daptomycin, Infection Prevention and Control Linezolid, MIC Creep, MRSA, Therapeutic Drug Monitoring, Vancomycin Resistance.

Abstract

Background: Hospital-acquired infections caused by methicillin-resistant Staphylococcus aureus (HA-MRSA) continue to pose a significant public health challenge, particularly in resource-limited settings across Africa. Vancomycin has long been considered the keystone of treatment; however, rising resistance rates and increasing reports of clinical failure are undermining its effectiveness. These developments highlight critical gaps in antimicrobial stewardship, infection prevention and control measures, and therapeutic drug monitoring systems. This systematic review aims to assess the prevalence of vancomycin resistance, analyze associated clinical outcomes, and evaluate alternative therapeutic options for HA- MRSA infections reported in African healthcare settings between 2015 and 2025.

Methods: A structured literature search was performed using PubMed, Google Scholar, and African Journals Online to identify relevant studies published from 2015 to 2025. Eligible articles involved adult inpatients with confirmed hospital-acquired MRSA infections and included data on vancomycin susceptibility profiles and/or clinical outcomes. Data regarding resistance rates, therapeutic effectiveness, and study characteristics were systematically extracted. Where appropriate, meta-analytic techniques were applied to calculate pooled prevalence estimates and effect sizes.

Results: Nine studies met the inclusion criteria, representing evidence from multiple African countries. Reported rates of vancomycin resistance among MRSA isolates ranged from 5% to 25%, with an observable upward trend after 2020. Several studies linked treatment failures to suboptimal dosing strategies, limited availability of therapeutic drug monitoring, and delays in antimicrobial susceptibility testing. While vancomycin generally retained clinical effectiveness, increases in minimum inhibitory concentrations (MIC creep) were frequently documented. Linezolid and daptomycin demonstrated superior clinical outcomes in selected contexts, particularly for MRSA-associated pneumonia and complicated skin and soft tissue infections.

Conclusion: Vancomycin remains a key therapeutic agent for healthcare-associated MRSA infections across Africa. However, emerging resistance patterns and MIC escalation necessitate urgent IPC and antimicrobial stewardship interventions. Strengtheningantimicrobial governance, expanding access to timely microbiological diagnostics, and implementing multicenter, methodologically robust clinical studies are critical to preserving therapeutic efficacy and improving patient outcomes.

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Additional Files

Published

2026-06-29

Issue

Vol. 1 No. 1 (2026): IMRJ

Section

Articles

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Copyright (c) 2026 Shahd Alfaki (Author)

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