Carriage of methicillin-resistant Staphylococcus aureus in a Queensland Indigenous community

Susan Vlack, Leonie Cox, Anton Y Peleg, Condy Canuto, Christine Stewart, Alzira Conlon, Alex Stephens, Philip Giffard, Flavia Huygens, Adam Mollinger, Renu Vohra, James S McCarthy
Medical Journal of Australia 2006 June 5, 184 (11): 556-9

OBJECTIVE: To determine the prevalence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) carriage and infection among children living in an Indigenous community in Queensland.

DESIGN, SETTING AND PARTICIPANTS: Swabs for culture of S. aureus were collected from the nose, throat and skin wounds of primary school children.

MAIN OUTCOME MEASURES: MRSA carriage, antibiotic sensitivity, genotype, and presence of the virulence factor Panton-Valentine leukocidin (PVL); and epidemiological risk factors for MRSA carriage.

RESULTS: 92 (59%) of 157 eligible children were included in the study. Twenty-seven (29%) carried S. aureus; 14 of these (15% of total) carried MRSA. MRSA was isolated from 29% of wound swabs, 8% of nose swabs, and 1% of throat swabs. Fourteen of 15 MRSA isolates were sensitive to all non-beta-lactam antibiotics tested. Eight children (9%) carried CA-MRSA clonal types: six carried the Queensland clone (ST93), and two carried the South West Pacific clone (ST30). All these isolates carried the virulence factor PVL. The remaining six children carried a hospital-associated MRSA strain (ST5), negative for PVL.

CONCLUSIONS: We have identified a high prevalence of CA-MRSA carriage in school children from a Queensland Indigenous community. In this setting, antibiotics with activity against CA-MRSA should be considered for empiric therapy of suspected staphylococcal infection. Larger community-based studies are needed to improve our understanding of the epidemiology of CA-MRSA, and to assist in the development of therapeutic guidelines for this important infection.

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