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In Australia, S. aureus rates may be higher among Aboriginal populations
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The incidence of Staphylococcus aureus may be almost six times higher among the Aboriginal population than it is in the general population, according to results of a recent study conducted in Northern Territory in Australia.
Researchers conducted a case-control study using data from the Royal Darwin Hospital to determine the source of CA-MRSA infections. They compared infections that resulted from non-multidrug-resistant MRSA, methicillin-susceptible S. aureus (MSSA) or multidrug-resistant MRSA.
The OR for S. aureus bacteremia in the Aboriginal population compared with that of the general population was 5.8 (95% CI; 3.8-8.9).
Female sex (OR 1.5; 95% CI; 1.1-2.0) and residence in a remote area (OR 1.8; 95% CI; 1.2-2.5) were associated with non-multidrug-resistant MRSA compared to MSSA; but the clinical outcomes for those infections were similar. This suggests that CA-MRSA may be emerging from remote Aboriginal communities, but that there is no difference in the virulence of CA-MRSA strains compared to the circulating MSSA strains. However, the presence of Panton-Valentine leukocidin in infecting strains was associated with an OR of 2.2 (95% CI; 1.1-4.6) for the outcome of sepsis in patients with non-multidrug-resistant MRSA.
In contrast with other studies which have shown an association between ethnicity and CA-MRSA, this study found no such association. However there was a strong link between rates of S. aureus and measures of socio-economic disadvantage and geographical remoteness.
Steven Tong, infectious diseases physician at the Menzies School of Health Research was involved in the study. “We make a point that infection control efforts may need to be targeted at virulent organisms rather than purely at resistant organisms, and furthermore, that rather than concentrating primarily on hospitals, community level interventions are required to improve the living conditions for Aboriginal people in remote communities to prevent the emergence and transmission of CA-MRSA strains,” he told Infectious Disease News. – by Rob Volansky
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