title: Community-onset Staphylococcus aureus infections presenting to general practices in South-eastern Australia.
abstract: Community-acquired Staphylococcus aureus infections are a public health concern, yet little is known about infections that do not present to hospital. We identified community-onset S. aureus infections via specimens submitted to a community-based pathology service. Referring doctors confirmed eligibility and described infection site, severity and treatment. Isolates were characterized on antibiotic resistance, PFGE, MLST/SCCmec, and Panton-Valentine leukocidin (PVL), representing 106 community-onset infections; 34 non-multiresistant methicillin-resistant S. aureus (nmMRSA) (resistant to <3 non-β-lactam antibiotics), 15 multiply antibiotic-resistant MRSA (mMRSA) and 57 methicillin-sensitive S. aureus (MSSA). Most (93%) were skin and soft tissue infections. PVL genes were carried by 42% of nmMRSA isolates [95% confidence interval (CI) 26-61] and 15% of MSSA (95% CI 8-28). PVL was associated with infections of the trunk, head or neck (56·4% vs. 24·3%, P=0·005) in younger patients (23 vs. 52 years, P<0·001), and with boils or abscesses (OR 8·67, 95% CI 2·9-26·2), suggesting underlying differences in exposure and/or pathogenesis.
authors.affiliation: The University of Melbourne, Melbourne, Australia.
authors.forename: C M
authors.initials: CM
authors.lastname: Bennett
authors.affiliation: Department of Microbiology and Infectious Diseases, PathWest Laboratory Medicine-WA, Royal Perth Hospital, Australia.
authors.forename: G W
authors.initials: GW
authors.lastname: Coombs
authors.affiliation: Austin Health, Melbourne, Australia.
authors.forename: G M
authors.initials: GM
authors.lastname: Wood
authors.affiliation: The University of Melbourne, Melbourne, Australia.
authors.forename: B P
authors.initials: BP
authors.lastname: Howden
authors.affiliation: The University of Melbourne, Melbourne, Australia.
authors.forename: L E A
authors.initials: LE
authors.lastname: Johnson
authors.affiliation: The University of Melbourne, Melbourne, Australia.
authors.forename: D
authors.initials: D
authors.lastname: White
authors.affiliation: The University of Melbourne, Melbourne, Australia.
authors.forename: P D R
authors.initials: PD
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification / Q000472:pathogenicity; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification* / Q000472:pathogenicity; D014739:Victoria / Q000453:epidemiology; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents