Skin infections in Australian Aboriginal children: a narrative review

Davidson, Lucy; Knight, Jessica; Bowen, Asha C

doi:10.5694/mja2.50361

Cited by 51 publications

(57 citation statements)

References 74 publications

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“…They can represent impetiginization of the skin secondary to excoriation of the lesions. Alternatively, similar to our patient, they can cause cellulitis and/or abscess [7,8].…”

Section: Discussionsupporting

confidence: 73%

Non-Classic (Surrepticius) Scabies Presenting as Erythematous Painful Palmar Pustules in an Octagenarian

Cohen¹,

Crowley²,

Erickson

et al. 2020

Cureus

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Sarcoptes scabiei classically presents with pruritic burrows. In addition to finger and toe web lesions, the penis and scrotum of men, the breast and areola of women, and the buttocks and axillae of both gender are common locations for mite-associated lesions. Scabies surrepticius refers to mite-related lesions that are not classical in morphology and/or distribution; there are several subtypes of non-classic or atypical scabies. Scabies surrepticius not only occurs in immunosuppressed individuals, but also in infants and children, and in elderly patients. An elderly woman developed mite-related bilateral erythematous painful palmar pustules that were clinically suspicious for a primary neutrophilic dermatosis; she also had a concurrent bacterial infection. The diagnosis of surrepticius scabies was established after evaluation of the deeper levels of her tissue biopsy specimen demonstrated a mite in the epidermis. All of her symptoms and lesions resolved after treatment with oral and topical antiscabetic therapy, and systemic antibiotics. Since the clinical presentation of the mite-related lesions can mimic those of other dermatologic or systemic conditions, a high degree of suspicion for the diagnosis of mite infestation must be entertained. Therefore, the clinician should consider the possibility of scabies surrepticius in any patient who develops new cutaneous lesions that are not typical for a defined dermatosis or do not resolve or improve after treatment.

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“…They can represent impetiginization of the skin secondary to excoriation of the lesions. Alternatively, similar to our patient, they can cause cellulitis and/or abscess [7,8].…”

Section: Discussionsupporting

confidence: 73%

Non-Classic (Surrepticius) Scabies Presenting as Erythematous Painful Palmar Pustules in an Octagenarian

Cohen¹,

Crowley²,

Erickson

et al. 2020

Cureus

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“…Social determinants such as household overcrowding are the major factors underlying high rates of invasive GAS disease in disadvantaged populations 23 . The incidence of impetigo, which predisposes to invasive GAS disease, is higher among Indigenous than non‐Indigenous Australians; measures for preventing impetigo include handwashing and chlorinated or salty swimming pools 24 . The higher incidence of invasive GAS disease in tropical areas of WA is consistent with data for lower leg cellulitis in WA, primarily caused by β‐haemolytic streptococci 14 .…”

Section: Discussionmentioning

confidence: 99%

Increasing incidence of invasive group A streptococcal disease in Western Australia, particularly among Indigenous people

Wright

Moorin

Pearson

et al. 2021

Medical Journal of Australia

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Invasive Streptococcus pyogenes (group A Streptococcus, GAS) infections are associated with high morbidity, mortality, and financial costs. 1 Reports of increasing incidence in Australia 2 and overseas 3 justify the surveillance of GAS infections. Contemporary estimates of disease burden are essential for assessing the value of GAS vaccine candidates 4 and for policies regarding post-exposure prophylaxis for close contacts of people with GAS infections. 5 In Australia, invasive GAS infections are notifiable only in Queensland (incidence [2019], 6.7 cases per 100 000 population 6 ) and the Northern Territory (incidence [2018], 31.2 cases per 100 000 population 7 ). It was recently estimated that the overall incidence of invasive GAS disease in Australia during 2017-18 was 8.3 cases per 100 000 population, 2 but it is higher among Indigenous Australians; the estimated incidence in the Northern Territory (2011-2013) was 69.7 cases per 100 000 population. 8 Western Australia is the largest Australian state, covering about one-third of the continent; the population was 2.6 million people in 2018 (10% of the Australian population), including about 2 million living in the capital, Perth, and 4% of the population were Indigenous Australians. 9,10 The climate ranges from tropical in the north, desert in the central regions, to temperate in the south. The climate of the Kimberley and Pilbara regions is tropical, and the proportion of Indigenous people is higher here than in other WA regions (2016: Kimberley, 42%; Pilbara, 14%). 11 Regional, climate-based, and demographic variation in healthrelated variables can accordingly be explored in WA, as in our previous investigation of lower leg cellulitis, based on linked hospital and emergency department data. [12][13][14] Differences between Indigenous and non-Indigenous Australians in GAS disease burden have previously been reported. 2 In this investigation, we quantified the burden of invasive GAS infections in WA during 2000-2018 in terms of incidence, length of hospital stay, and all-cause mortality for the two population groups. MethodsThe reporting of our population-based data linkage study conforms with the Reporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement. 15 Data sourcesThe WA Data Linkage System used best practice methods 16 to link the Hospital Morbidity Data Collection (HMDC; comprising all WA public and private hospital records), PathWest pathology data (PathWest is the government-owned pathology services provider for metropolitan and regional public hospitals), and death registrations. The linked data included a non-identifying number for each included person. Selection of casesWe analysed data for cases of GAS infection during 1 January 2000 -31 December 2018. Microbiologically confirmed cases

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“…This increase may be associated with recent guidelines recommending trimethoprim/sulfamethoxazole as first-line treatment for skin and soft tissue infections (SSTI), particularly due to methicillin-resistant S. aureus . 41 , 42 Regions in northern Australia with a higher prevalence of SSTIs appear to also have higher uropathogen resistance rates to trimethoprim/sulfamethoxazole. 8 , 26 , 43 Trimethoprim/sulfamethoxazole is mainly indicated for use in children, and while our data would need to be stratified into age groups for more detailed commentary, this recommendation may need to be revised.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance in uropathogens across northern Australia 2007–20 and impact on treatment guidelines

Cuningham

Perera²,

Coulter

et al. 2021

JAC-Antimicrobial Resistance

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Background Urinary tract infections are common and are increasingly resistant to antibiotic therapy. Northern Australia is a sparsely populated region with limited access to healthcare, a relatively high burden of disease, a substantial regional and remote population, and high rates of antibiotic resistance in skin pathogens. Objectives To explore trends in antibiotic resistance for common uropathogens Escherichia coli and Klebsiella pneumoniae in northern Australia, and how these relate to current treatment guidelines in the community and hospital settings. Methods We used data from an antibiotic resistance surveillance system. We calculated the monthly and yearly percentage of isolates that were resistant in each antibiotic class, by bacterium. We analysed resistance proportions geographically and temporally, stratifying by healthcare setting. Using simple linear regression, we investigated longitudinal trends in monthly resistance proportions and correlation between community and hospital isolates. Results Our analysis included 177 223 urinary isolates from four pathology providers between 2007 and 2020. Resistance to most studied antibiotics remained <20% (for E. coli and K. pneumoniae, respectively, in 2019: amoxicillin/clavulanate 16%, 5%; cefazolin 17%, 8%; nitrofurantoin 1%, 31%; trimethoprim 36%, 17%; gentamicin 7%, 2%; extended-spectrum cephalosporins 8%, 5%), but many are increasing by 1%–3% (absolute) per year. Patterns of resistance were similar between isolates from community and hospital patients. Conclusions Antibiotic resistance in uropathogens is increasing in northern Australia, but treatment guidelines generally remain appropriate for empirical therapy of patients with suspected infection (except trimethoprim in some settings). Our findings demonstrate the importance of local surveillance data (HOTspots) to inform clinical decision making and guidelines.

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Skin infections in Australian Aboriginal children: a narrative review

Cited by 51 publications

References 74 publications

Non-Classic (Surrepticius) Scabies Presenting as Erythematous Painful Palmar Pustules in an Octagenarian

Non-Classic (Surrepticius) Scabies Presenting as Erythematous Painful Palmar Pustules in an Octagenarian

Increasing incidence of invasive group A streptococcal disease in Western Australia, particularly among Indigenous people

Antibiotic resistance in uropathogens across northern Australia 2007–20 and impact on treatment guidelines

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