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

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.

Treatment of an abscess after massive autologous fat transplantation for breast augmentation with real-time ultrasonography-guided liposuction

“…In previous studies and case reports, Escherichia coli infection due to skin contamination was reported to be the most common cause; however, MRSA and K. pneumoniae were detected in the abscess culture of the present patient [9]. A prospective study in Australia found that 60% of all soft tissue infections were caused by commu-nity-acquired MRSA [10]. In this patient, the mechanism causing the infection was unclear, but we assumed that infection occurred in the fat tissue because of improper storage.…”

Targeting the Bacterial Protective Armour; Challenges and Novel Strategies in the Treatment of Microbial Biofilm

“…Staphylococcus aureus is a Gram-positive cocci-shaped bacterium that forms part of the normal flora on the body and is frequently isolated from the skin, respiratory tract, and female lower reproductive tract [ 11 , 12 ]. Infections by S. aureus were once treatable by penicillin.…”

“…However, increasing resistance towards penicillin led to the introduction of methicillin for the treatment in 1960 [ 13 ]. However, soon after that, S. aureus acquired resistance towards methicillin, giving rise to methicillin-resistant S. aureus (MRSA) clones [ 12 , 13 ]. Currently, the Center for Disease Control (CDC) reported that infections by MRSA are the second most common cause of HAI in the USA [ 14 ].…”

Antibiotic Prophylaxis for Melioidosis in Patients Receiving Hemodialysis in the Tropics? One Size Does Not Fit All

“…Furthermore, TMP/SMX is an important antibiotic in Australia, where community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is common and seen more frequently in HD patients. 11 Trimethoprim/SMX resistance is presently low in Australian CA-MRSA isolates 11 but ongoing responsible antimicrobial stewardship is necessary.…”