Staphylococcus aureus ‘Down Under’: contemporary epidemiology of S. aureus in Australia, New Zealand, and the South West Pacific

Abstract

The clinical and molecular epidemiology of Staphylococcus aureus disease has changed considerably over the past two decades, particularly with the emergence and spread of community-associated methicillin-resistant S. aureus (CA-MRSA) clones. Indeed, some of the first global descriptions of CA-MRSA were from remote indigenous communities in Western Australia, and from Pacific Peoples in New Zealand. The epidemiology of S. aureus infections in the South West Pacific has several unique features, largely because of the relative geographical isolation and unique indigenous communities residing in this region. In particular, a number of distinct CA-MRSA clones circulate in Australia and New Zealand, such as sequence type (ST) 93 methicillin-resistant S. aureus (MRSA) (Queensland clone) and clonal complex 75 S. aureus (Staphylococcus argenteus) in Australia, and ST30 MRSA (Southwest Pacific clone) in New Zealand. In addition, there is a disproportionate burden of S. aureus disease in indigenous paediatric populations, particularly in remote Aboriginal communities in Australia, and in Pacific Peoples and Maori in New Zealand. In this review, we provide a contemporary overview of the clinical and molecular epidemiology of S. aureus disease in the South West Pacific region, with a particular focus on features distinct to this region.

High burden of complicated skin and soft tissue infections in the Indigenous population of Central Australia due to dominant Panton Valentine leucocidin clones ST93-MRSA and CC121-MSSA

“…The association of CC121 with SSTI is consistent with the international literature and CC121 is phenotypically usually MSSA [22]. The molecular epidemiology of MSSA infections has been studied in less detail than CA-MRSA [23], but CC121 is commonly associated with SSTIs in Australia. However, the high prevalence of CC121 in our study (30%) is greater than that reported elsewhere in the Northern Territory ‘Top End’ and metropolitan centers [9, 18], and may be a unique feature of the Central Australian region.…”

Review article: Sepsis in the emergency department – Part 3: Treatment

“…Community‐acquired methicillin‐resistant Staphylococcus aureus (‘CA‐MRSA’) now accounts for 25% of S. aureus infections in some parts of Australia, with risk factors including race (Aboriginal, Maori, Pacific Islander), communal living (prisons, boarding houses), i.v. drug use and poor self‐care . Dominant CA‐MRSA clones and resistance patterns can vary widely between locations, so local data and early infectious diseases specialist input are required to guide empiric therapy …”

“…drug use and poor self-care. 12,13 Dominant CA-MRSA clones and resistance patterns can vary widely between locations, so local data and early infectious diseases specialist input are required to guide empiric therapy. 14…”

Detection of methicillin resistant Staphylococcus areus isolated from nasal carriage of health care workers by polymerase chain reaction

“…methicillin) (Van Hal et al, 2007). The prevalence of MRSA infections have increased dramatically over the past two decades (Williamson et al, 2014). According to Baiu & AL-Abdli (2015), due to antibiotics resistance, MRSA infections required more complicated treatment.…”