Increased Incidence of Methicillin-Resistant Staphylococcus aureus Skin and Soft Tissue Abscesses in Indigenous Children in North Queensland

Introduction The rise of Methicillin-resistant Staphylococcus aureus (MRSA) is a major concern in Australia, particularly affecting Aboriginal and Torres Strait Islander (Indigenous) people. This study aimed to identify the incidence of MRSA in Indigenous compared to non-Indigenous children with skin and soft tissue abscesses (SSTAs). Methodology Following ethical approval, electronic hospital records were retrospectively reviewed to identify microbiological swabs from patients who underwent incision and drainage of SSTAs at Townsville University Hospital between January 2020 and December 2024. Patients under 16 years with their ethnicity data were included. Results Four hundred and fifty-two children met the inclusion criteria. Two hundred and thirty-four (52%) identified as Indigenous and 218 (48%) as non-Indigenous. MRSA was isolated in significantly more Indigenous (41%, 96/234) than non-Indigenous (21%, 45/218) patients (p<0.001). Indigenous children were 2.7 times more likely to have MRSA (OR: 2.7, 95% CI: 1.9, 3.8). Methicillin-sensitive Staphylococcus aureus (MSSA) was cultured in 38% (174/452) of samples. Other cultured organisms included Streptococcus species (10%), mixed skin flora (5%), and mixed enteric and anaerobic bacteria (4%). Other multi-resistant organisms included Extended-Spectrum Beta-Lactamase-producing Escherichia coli (E. Coli) (1/452) and Mycobacterium abscessus (1/452). SSTAs most commonly affected the limbs (29%), followed by the head and neck (23%), buttocks (15%), torso (9%), perianal/perineal (9%), and groin (6%). Most SSTAs were drained by the paediatric surgeons (70%), followed by orthopaedic surgeons (18%), with smaller numbers by maxillofacial, ear-nose and throat, and general surgeons. Conclusion We identified higher rates of MRSA in Indigenous children with SSTAs compared to non-Indigenous children, justifying empiric MRSA antimicrobial coverage for Indigenous children. Future prospective studies should include follow-up to assess rates of recurrence, side effects of antibiotics, and whether the same trend continues into adulthood.