Global Implications of the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus in Indigenous Populations

• Published in: Clinical infectious diseases 2008-06, Vol.46 (12), p.1871-1878
• Main Authors: Tong, Steven Y. C., McDonald, Malcolm I., Holt, Deborah C., Currie, Bart J.
• Format: Article
• Language: English
• Subjects: Antibiotics; Australia - epidemiology; Bacterial diseases; Biological and medical sciences; Communities; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Disease transmission; Epidemiology; Gene Transfer, Horizontal; Human bacterial diseases; Humans; Indigenous populations; Infections; Infectious diseases; Living conditions; Medical sciences; Methicillin Resistance - genetics; Methicillin resistant staphylococcus aureus; Molecules; Native peoples; Population Groups; Review Article; Skin; Socioeconomic Factors; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal infections, streptococcal infections, pneumococcal infections; Staphylococcus; Staphylococcus aureus; Staphylococcus aureus - classification; Staphylococcus aureus - drug effects; Staphylococcus aureus - genetics; Staphylococcus aureus - isolation & purification; Staphylococcus infections
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/588301

The emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) in Australia may have been facilitated by conditions in socially disadvantaged populations—particularly, remote Australian Aboriginal communities. The appearance of community-associated MRSA was first noticed in Australia during the early 1980s; subsequently, several genetically diverse strains have independently emerged from geographically distinct regions. Molecular and epidemiological studies support the role of genetic transfer of resistance determinants (SCCmecIV) in this process. Conditions in Aboriginal communities—namely, domestic crowding, poor hygiene, and high rates of scabies, pyoderma, and antibiotic use—have facilitated both the clonal expansion and de novo emergence of strains of community-associated MRSA. Combating the worldwide emergence and spread of community-associated MRSA may require novel community-level control strategies targeted at specific groups, such as remote Indigenous populations.