Epidemiology and Infection

Short Report

Skin infections among Indigenous Australians in an urban setting in Far North Queensland

P. C. VALERYa1a2 c1, M. WENITONGa3, V. CLEMENTSa1a4, M. SHEELa5, D. McMILLANa5, J. STIRLINGa1, K. S. SRIPRAKASHa5, M. BATZLOFFa6, R. VOHRAa7 and J. S. McCARTHYa2a8

a1 Indigenous Health Research Program, Queensland Institute of Medical Research, Australia

a2 Australian Centre for International & Tropical Health, University of Queensland

a3 Wuchopperen Health Service, Cairns, Australia

a4 National Centre for Epidemiology & Population Health, The Australian National University, Australia

a5 Bacterial Pathogenesis Laboratory, Queensland Institute of Medical Research, Australia

a6 Molecular Immunology Laboratory, Queensland Institute of Medical Research, Australia

a7 Queensland Medical Laboratory, Brisbane, Australia

a8 Clinical Tropical Medicine, Queensland Institute of Medical Research, Australia

Abstract

Skin infections are highly prevalent in many Australian Aboriginal communities. This study aimed to determine the prevalence of group A streptococcus (GAS) and Staphylococcus aureus in skin sores of Indigenous people living in an urban setting. We undertook a cross-sectional study of 173 children and youths attending the Wuchopperen Clinic (Cairns) for treatment of skin infections. Participants were interviewed using a structured questionnaire, and a skin lesion swab obtained. The median age was 5·3 years, with 42% identifying themselves as Torres Strait Islanders and 34% as Aboriginal. Impetigo (65%) was the most frequent diagnosis reported followed by scabies (19%); 79% of the lesions had erythema and 70% had exudate. Of 118 lesions, 114 were positive for pathogenic bacteria, with GAS isolated in 84 cases and S. aureus in 92; both these species were recovered from 63 lesions. Significant diversity of emm-types of GAS was associated with skin lesions in Indigenous patients (22 emm-types identified). Fifteen of the 92 S. aureus isolates were suggestive of being community-acquired on the basis of antimicrobial susceptibility profile and nine of these strains were co-cultured from nine lesions. These results have implications for future changes of antibiotic policies for the treatment of skin infections in this population.

(Accepted September 17 2007)

(Online publication October 24 2007)

Correspondence:

c1 Author for correspondence: Dr P. C. Valery, Epidemiology & Population Health Division, Queensland Institute of Medical Research, Post Office, Royal Brisbane Hospital, Queensland, Australia 4029. (Email: Patricia.Valery@qimr.edu.au)

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