Community-onsetStaphylococcus aureusinfections presenting to general practices in South-eastern Australia

Abstract

SUMMARYCommunity-acquiredStaphylococcus aureusinfections are a public health concern, yet little is known about infections that do not present to hospital. We identified community-onsetS. aureusinfections 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-resistantS. aureus(nmMRSA) (resistant to <3 non-β-lactam antibiotics), 15 multiply antibiotic-resistant MRSA (mMRSA) and 57 methicillin-sensitiveS. 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 (23vs. 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.