CA-MRSA全球扩散对澳大利亚原住民的影响

David

Clinical Infectious Diseases 2008;46:1871–1878

REVIEW ARTICLE
Global Implications of the Emergence of Community-Associated Methicillin-Resistant Staphylococcus aureus in Indigenous Populations
CA-MRSA全球扩散对澳大利亚原住民的影响
Steven Y. C. Tong,1,2 Malcolm I. McDonald,1 Deborah C. Holt,1 and Bart J. Currie1,2

1Menzies School of Health Research, Charles Darwin University, and 2Northern Territory Clinical School, Royal Darwin Hospital, Darwin, Australia

The emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA) in Australia may have been facilitated by conditions in socially disadvantaged populations-particularly, remote Australian Aboriginal communities. The appearance of community-associated MRSA was first noticed in Australia during the early 1980s; subsequently, several genetically diverse strains have independently emerged from geographically distinct regions. Molecular and epidemiological studies support the role of genetic transfer of resistance determinants (SCCmecIV) in this process. Conditions in Aboriginal communities-namely, domestic crowding, poor hygiene, and high rates of scabies, pyoderma, and antibiotic use-have facilitated both the clonal expansion and de novo emergence of strains of community-associated MRSA. Combating the worldwide emergence and spread of community-associated MRSA may require novel community-level control strategies targeted at specific groups, such as remote Indigenous populations.