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

  • P. C. VALERY (a1) (a2), M. WENITONG (a3), V. CLEMENTS (a1) (a4), M. SHEEL (a5), D. McMILLAN (a5), J. STIRLING (a1), K. S. SRIPRAKASH (a5), M. BATZLOFF (a6), R. VOHRA (a7) and J. S. McCARTHY (a2) (a8)
  • DOI:
  • Published online: 24 October 2007

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.

Corresponding author
*Author for correspondence: Dr P. C. Valery, Epidemiology & Population Health Division, Queensland Institute of Medical Research, Post Office, Royal Brisbane Hospital, Queensland, Australia4029. (Email:
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1. BJ Currie , JR Carapetis . Skin infections and infestations in Aboriginal communities in northern Australia. Australasian Journal of Dermatology 2000; 41: 139143.

4. IB Gosbell . Epidemiology, clinical features and management of infections due to community methicillin-resistant Staphylococcus aureus (cMRSA). Internal Medical Journal 2005; 35 (Suppl. 2): S120135.

6. DL Heath , KS Panaretto . Nutrition status of primary school children in Townsville. Australian Journal of Rural Health 2005; 13: 282289.

8. MW Cunningham . Pathogenesis of group A streptococcal infections. Clinical Microbiology Reviews 2000; 13: 470511.

9. R Facklam , emm typing and validation of provisional M types for group A streptococci. Emerging Infectious Diseases 1999; 5: 247253.

10. MI McDonald , Molecular typing of Streptococcus pyogenes from remote Aboriginal communities where rheumatic fever is common and pyoderma is the predominant streptococcal infection. Epidemiology and Infection. Published online: 19 February 2007. doi:10.1017/S0950268807008023.

11. W Tewodros , G Kronvall . M protein gene (emm type) analysis of group A beta-hemolytic streptococci from Ethiopia reveals unique patterns. Journal of Clinical Microbiology 2005; 43: 43694376.

13. MI McDonald , Low rates of streptococcal pharyngitis and high rates of pyoderma in Australian aboriginal communities where acute rheumatic fever is hyperendemic. Clinical Infectious Diseases 2006; 43: 683689.

14. KF McGregor , Group A streptococci from a remote community have novel multilocus genotypes but share emm types and housekeeping alleles with isolates from worldwide sources. Journal of Infectious Diseases 2004; 189: 717723.

16. MC Hu , Immunogenicity of a 26-valent group A streptococcal vaccine. Infection and Immunity 2002; 70: 21712177.

17. M McDonald , Use of a single-nucleotide polymorphism genotyping system to demonstrate the unique epidemiology of methicillin-resistant Staphylococcus aureus in remote aboriginal communities. Journal of Clinical Microbiology 2006; 44: 37203727.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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