Social determinants and community-level risk factors in CA-MRSA transmission among disadvantaged populations in North America: A scoping review

Community-acquired methicillin-resistant <i>Staphylococcus aureus</i> (CA-MRSA) is a significant public health concern, disproportionately affecting socioeconomically disadvantaged populations, including individuals experiencing poverty, homelessness, incarceration, and injection drug use. This scoping review synthesizes existing literature on factors influencing CA-MRSA occurrence and community transmission in these populations. A comprehensive search of PubMed, MEDLINE, and Scopus for studies published between January 2000 and February 2024 identified 3,223 articles, of which 40 met the inclusion criteria. Findings indicate that the CA-MRSA burden remains high, with community transmission influenced by factors, such as limited access to hygiene resources, structural barriers to care, and social network dynamics. Surveillance and intervention strategies remain largely healthcare-focused, with limited data on community-level transmission and risk. This review highlights the urgent need for targeted public health interventions and the adoption of expanded, innovative surveillance methods, such as genomic epidemiology, to better track and mitigate CA-MRSA transmission in vulnerable populations. As antibiotic resistance continues to rise, future research should prioritize longitudinal studies and community-based surveillance to develop effective, population-specific infection prevention, and control strategies.