The rise of methicillin resistant Staphylococcus aureus: now the dominant cause of skin and soft tissue infection in Central Australia

The rise of methicillin resistant Staphylococcus aureus: now the dominant cause of skin and soft tissue infection in Central Australia Journal Article

Epidemiology and Infection

• Author(s): Macmorran, E., Harch, S., Athan, E., Lane, S., Tong, S., Crawford, L., Krishnaswamy, S., Hewagama, S.
• Published: 2017
• Publisher: Cambridge University Press
• Volume: 145
• ISBN: 0950-2688

Link to resource Report broken link

Abstract: This study aimed to examine the epidemiology and treatment outcomes of community-onset purulent staphylococcal skin and soft tissue infections (SSTI) in Central Australia. We performed a prospective observational study of patients hospitalised with community-onset purulent staphylococcal SSTI (n = 160). Indigenous patients accounted for 78% of cases. Patients were predominantly young adults; however, there were high rates of co-morbid disease. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was the dominant phenotype, accounting for 60% of cases. Hospitalisation during the preceding 6 months, and haemodialysis dependence were significant predictors of CA-MRSA infection on univariate analysis. Clinical presentation and treatment outcomes were found to be comparable for methicillin-susceptible S. aureus (MSSA) and methicillin-resistant cases. All MRSA isolates were characterised as non-multi-resistant, with this term used interchangeably with CA-MRSA in this analysis. We did not find an association between receipt of an active antimicrobial agent within the first 48 h, and progression of infection; need for further surgical debridement; unplanned General Practitioner or hospital re-presentation; or need for further antibiotics. At least one adverse outcome was experienced by 39% of patients. Clindamycin resistance was common, while rates of trimethoprim–sulfamethoxazole resistance were low. This study suggested the possibility of healthcare-associated transmission of CA-MRSA. This is the first Australian report of CA-MRSA superseding MSSA as the cause of community onset staphylococcal SSTI.

• Urls: https://www.cambridge.org/core/article/rise-of-methicillin-resistant-staphylococcus-aureus-now-the-dominant-cause-of-skin-and-soft-tissue-infection-in-central-australia/2970E876B69BB192BC9BD58C45398EC7
• Keywords: Staphylococcus aureus, Methicillin - S. aureus resistant to (MRSA), Public health microbiology, Soft tissue infections, Community epidemics