Incidence of community onset MRSA in Australia: least reported where it is Most prevalent

Abstract Background This is the first review of literature and synthesis of data on community onset methicillin resistant Staphylococcus aureus (CO-MRSA) infections in Australia. Incidence of CO-MRSA varies considerably in Australia, depending on geographic and demographic factors. Methods Data for...

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Main Authors: Jessica K. Cameron, Lisa Hall, Steven Y. C. Tong, David L. Paterson, Kate Halton
Format: Article
Language:English
Published: BMC 2019-02-01
Series:Antimicrobial Resistance and Infection Control
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13756-019-0485-7
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spelling doaj-51eddc9ab76c4b6d94778245f775b5ef2020-11-25T01:21:50ZengBMCAntimicrobial Resistance and Infection Control2047-29942019-02-01811910.1186/s13756-019-0485-7Incidence of community onset MRSA in Australia: least reported where it is Most prevalentJessica K. Cameron0Lisa Hall1Steven Y. C. Tong2David L. Paterson3Kate Halton4Australian Centre for Health Services Innovation and the Institute for Health and Biomedical Innovation, Queensland University TechnologyAustralian Centre for Health Services Innovation and the Institute for Health and Biomedical Innovation, Queensland University TechnologyVictorian Infectious Disease Service, The Royal Melbourne Hospital, and Doherty Department University of Melbourne, Peter Doherty Institute for Infection and ImmunityUQ Centre for Clinical Research, University of QueenslandAustralian Centre for Health Services Innovation and the Institute for Health and Biomedical Innovation, Queensland University TechnologyAbstract Background This is the first review of literature and synthesis of data on community onset methicillin resistant Staphylococcus aureus (CO-MRSA) infections in Australia. Incidence of CO-MRSA varies considerably in Australia, depending on geographic and demographic factors. Methods Data for the rates of MRSA infections were collected from articles identified using PubMed, Scopus, the grey literature and data from State and Federal Government Surveillance Systems. We synthesized data and developed a framework for how data was selected, collated, linked, organized and interpreted. Results The results of our literature search demonstrates considerable gaps in the reporting of CO-MRSA in Australia. Consequently, total incidences were under reported; however the available data suggests the incidence varied between 44 (Tasmania) and 388 (southern Northern Territory) cases per 100,000 person years. Hospitalised cases of CO-MRSA varied between 3.8 (regional Victoria) and 329 (southern Northern Territory). Taking the median percentage of infections by site for all regions available, skin and soft tissue infections (SSTIs) consisted of 56% of hospitalized CO-MRSA, compared with bacteremias, which represented 14%. No region had a complete data set of CO-MRSA infections treated in out-patient settings and so incidences were underestimates. Nevertheless, estimates of the incidence of CO-MRSA treated outside hospitals varied between 11.3 (Melbourne) and 285 (Northern Territory) per 100,000 person-years. These infections were chiefly SSTIs, although urinary tract infections were also noted. Incidences of CO-MRSA blood-stream infections and outpatient skin and soft tissue infections have been increasing with time, except in Tasmania. CO-MRSA is observed to affect people living in remote areas and areas of socioeconomic disadvantage disproportionately. Conclusions We generated the first estimates of the incidence of CO-MRSA infections in Australia and identified stark regional differences in the nature and frequency of infections. Critically, we demonstrate that there has been a lack of consistency in reporting CO-MRSA and a general dearth of data. The only government in Australia that requires reporting of CO-MRSA is the Tasmanian, where the infection was least prevalent. Some regions of Australia have very high incidences of CO-MRSA. To improve surveillance and inform effective interventions, we recommend a standardized national reporting system in Australia that reports infections at a range of infection sites, has broad geographic coverage and consistent use of terminology. We have identified limitations in the available data that hinder understanding the prevalence of CO-MRSA.http://link.springer.com/article/10.1186/s13756-019-0485-7Staphylococcus aureusMethicillin resistant Staphylococcus aureusCommunityAntimicrobial resistanceAustralia
collection DOAJ
language English
format Article
sources DOAJ
author Jessica K. Cameron
Lisa Hall
Steven Y. C. Tong
David L. Paterson
Kate Halton
spellingShingle Jessica K. Cameron
Lisa Hall
Steven Y. C. Tong
David L. Paterson
Kate Halton
Incidence of community onset MRSA in Australia: least reported where it is Most prevalent
Antimicrobial Resistance and Infection Control
Staphylococcus aureus
Methicillin resistant Staphylococcus aureus
Community
Antimicrobial resistance
Australia
author_facet Jessica K. Cameron
Lisa Hall
Steven Y. C. Tong
David L. Paterson
Kate Halton
author_sort Jessica K. Cameron
title Incidence of community onset MRSA in Australia: least reported where it is Most prevalent
title_short Incidence of community onset MRSA in Australia: least reported where it is Most prevalent
title_full Incidence of community onset MRSA in Australia: least reported where it is Most prevalent
title_fullStr Incidence of community onset MRSA in Australia: least reported where it is Most prevalent
title_full_unstemmed Incidence of community onset MRSA in Australia: least reported where it is Most prevalent
title_sort incidence of community onset mrsa in australia: least reported where it is most prevalent
publisher BMC
series Antimicrobial Resistance and Infection Control
issn 2047-2994
publishDate 2019-02-01
description Abstract Background This is the first review of literature and synthesis of data on community onset methicillin resistant Staphylococcus aureus (CO-MRSA) infections in Australia. Incidence of CO-MRSA varies considerably in Australia, depending on geographic and demographic factors. Methods Data for the rates of MRSA infections were collected from articles identified using PubMed, Scopus, the grey literature and data from State and Federal Government Surveillance Systems. We synthesized data and developed a framework for how data was selected, collated, linked, organized and interpreted. Results The results of our literature search demonstrates considerable gaps in the reporting of CO-MRSA in Australia. Consequently, total incidences were under reported; however the available data suggests the incidence varied between 44 (Tasmania) and 388 (southern Northern Territory) cases per 100,000 person years. Hospitalised cases of CO-MRSA varied between 3.8 (regional Victoria) and 329 (southern Northern Territory). Taking the median percentage of infections by site for all regions available, skin and soft tissue infections (SSTIs) consisted of 56% of hospitalized CO-MRSA, compared with bacteremias, which represented 14%. No region had a complete data set of CO-MRSA infections treated in out-patient settings and so incidences were underestimates. Nevertheless, estimates of the incidence of CO-MRSA treated outside hospitals varied between 11.3 (Melbourne) and 285 (Northern Territory) per 100,000 person-years. These infections were chiefly SSTIs, although urinary tract infections were also noted. Incidences of CO-MRSA blood-stream infections and outpatient skin and soft tissue infections have been increasing with time, except in Tasmania. CO-MRSA is observed to affect people living in remote areas and areas of socioeconomic disadvantage disproportionately. Conclusions We generated the first estimates of the incidence of CO-MRSA infections in Australia and identified stark regional differences in the nature and frequency of infections. Critically, we demonstrate that there has been a lack of consistency in reporting CO-MRSA and a general dearth of data. The only government in Australia that requires reporting of CO-MRSA is the Tasmanian, where the infection was least prevalent. Some regions of Australia have very high incidences of CO-MRSA. To improve surveillance and inform effective interventions, we recommend a standardized national reporting system in Australia that reports infections at a range of infection sites, has broad geographic coverage and consistent use of terminology. We have identified limitations in the available data that hinder understanding the prevalence of CO-MRSA.
topic Staphylococcus aureus
Methicillin resistant Staphylococcus aureus
Community
Antimicrobial resistance
Australia
url http://link.springer.com/article/10.1186/s13756-019-0485-7
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