Abstract
ObjectiveCommunity-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) can cause bacterial skin infections that are common problems for Aboriginal children in New South Wales (NSW). MRSA is not notifiable in NSW and surveillance data describing incidence and prevalence are not routinely collected. The study aims to describe the epidemiology of CA-MRSA in Aboriginal children in the Hunter New England Local Health District (HNELHD).MethodsWe linked data from Pathology North Laboratory Management System (AUSLAB) and the HNELHD patient administration system from 33 hospital emergency departments. Data from 2008–2014 for CA-MRSA isolates were extracted. Demographic characteristics included age, gender, Aboriginality, rurality and seasonality.ResultsOf the 1222 individuals in this study, 408 (33.4%) were Aboriginal people. Aboriginal people were younger with 45.8% aged less than 10 years compared to 25.9% of non-Aboriginal people. Most isolates came from Aboriginal people who attended the regional Tamworth Hospital (193/511 isolates from 149 people). A larger proportion of Aboriginal people, compared to non-Aboriginal people, resided in outer regional (64.9% vs 37.2%) or remote/very remote areas (2.5% vs 0.5%). Most infections occurred in summer and early autumn. For Aboriginal patients, there was a downward trend through autumn, continuing through winter and spring.DiscussionAboriginal people at HNELHD emergency departments appear to represent a greater proportion of people with skin infections with CA-MRSA than non-Aboriginal people. CA-MRSA is not notifiable in NSW; however, pathology and hospital data are available and can provide valuable indicative data to health districts for planning and policy development.
Highlights
Aboriginal people accounted for 33.4% of Community-associated methicillin-resistant Staphylococcus aureus (CA-methicillin-resistant Staphylococcal aureus (MRSA)) first isolates in the study period while accounting for just 10.2% of the total population aged under 20 years in the wider Hunter New England Local Health District (HNELHD) population.[9]
The emergency department at the regional centre of Tamworth had the highest number of CA-MRSA isolates identified in Aboriginal people
A similar trend was reported for paediatric patients in Rhode Island, USA, where approximately 1.85 times as many CA-MRSA infections per emergency department visit occurred in summer and autumn.[11]
Summary
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) can cause bacterial skin infections that are common problems for Aboriginal children in New South Wales (NSW). Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) can cause bacterial skin infections that are common health problems for many Australian Aboriginal and Torres Strait Islander (hereafter Aboriginal) children and families in rural areas in New South Wales (NSW).[1] The term CAMRSA distinguishes the infection from MRSA acquired through health-care settings including hospitals. Community-associated MRSA in Aboriginal children attending emergency departments, NSW conditions and previous antimicrobial drug treatment.[4] MRSA is not notifiable in NSW and surveillance data describing its incidence and prevalence are not routinely collected Such data would be invaluable in the planning, implementation and evaluation of public health programmes designed to prevent and control CA-MRSA. We used routinely collected pathology data from wound and/or skin swabs collected in emergency departments of hospitals in the Hunter New England Local Health District (HNELHD) to describe the epidemiology of CA-MRSA in Aboriginal children and young people. Results will inform the development of health policy and community-based programmes to reduce the incidence and prevalence of the infection
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