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

Abstract

Abstract: Objectives: 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, the throat and
skin wounds of primary school children.
Main Outcome Measures: MRSA carriage, antibiotic sensitivity, genetic relatedness, presence of the
virulence factor Panton-Valentine leukocidin (pvl) and epidemiologic risk factors for MRSA carriage.
Results: Ninety two of 157 (59%) eligible children were included in the study. Twenty seven (29%) carried S.
aureus, 14 (15%) of whom 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--lactam
antibiotics tested. Eight children (9%) carried CA-MRSA clonal types; 6 children carried the Queensland
clone (ST93), while 2 carried the South West Pacific clone (ST30). All these isolates carried the virulence
factor pvl. The remaining 6 children carried a hospital-associated MRSA strain (ST5), all of which were
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.