• Written by Asha Bowen, Head, Skin Health, Telethon Kids Institute

Antibiotic-resistant infections already cause at least 700,000 deaths globally every year.

Although the phenomenon is most concerning for serious infections people are admitted to hospital with, antibiotic resistance means common bacterial infections could one day be impossible to treat.

Appropriately, the issue has received national and global attention in public health policy making.

But antibiotic resistance in remote Aboriginal and Torres Strait Islander communities has garnered minimal attention. Remote Indigenous communities are not mentioned in the current National Antimicrobial Resistance (AMR) Strategy, for example.

It’s in these parts of Australia, however, that antibiotic resistance is arguably having the most significant impact.


Read more: We can reverse antibiotic resistance in Australia. Here's how Sweden is doing it


A key example

Antibiotics are medications used to treat bacterial infections. But when bacteria are repeatedly exposed to antibiotics, they can adapt and survive against the antibiotics previously known to kill them.

Using antibiotics unwisely, for example for a viral infection, taking a low dose when a high dose is needed, or stopping a course of antibiotics before an infection has resolved, all contribute to antibiotic resistance.

In northern Australia, the bacteria Staphylococcus aureus, (or S. aureus for short, also known as golden staph) causes skin and soft tissue infections. When S. aureus becomes resistant to the antibiotics commonly used to treat these infections, we call it methicillin resistant S. aureus, or MRSA.

The rates of MRSA in northern Australia are significantly higher than elsewhere in the country. Recent government figures show among people with S. aureus infections, the rate of MRSA in remote and very remote areas was double that of major cities (roughly 40% versus 20%).

Australia doesn’t have a national surveillance system for monitoring rates of MRSA. So the figures can vary depending on the location, time period and the population studied.

Some studies have reported MRSA rates close to 60% in parts of central and northern Australia, compared to about 13% elsewhere in Australia.


Read more: Antibiotic shortages are putting Aboriginal kids at risk


What happens when the antibiotics don’t work?

Up to three-quarters of all people in remote Indigenous communities who attend a medical clinic each year present at some stage for treatment of a skin and soft tissue infection such as skin sores, boils or cellulitis.

The prevalence of MRSA in northern Australia means these people can no longer rely on simple, first line antibiotics for treatment.

Treatment failure because of antibiotic resistance means skin and soft tissue infections take longer to get better, and are more likely to spread to other people.

In more serious cases, the infection can invade past the skin and cause a bone, blood or lung infection. If this happens, the patient will likely need to be flown to a hospital thousands of kilometres away.

This issue is compounded when certain antibiotics are unavailable due to shortages.

Skin and soft tissue infections are often caused by the bacteria golden staph, which is increasingly resistant to antibiotics. From shutterstock.com

Why is antibiotic resistance so much higher in remote Indigenous communities?

The heavy burden of infections such as skin infections (as many as one in two remote living Aboriginal children suffer from a skin infection at any one time), ear infections, pneumonia, and sexually transmitted infections, mean antibiotics need to be prescribed frequently and broadly. This allows antibiotic resistance to spread.

In addition to high levels of infection, underlying social determinants of health like household crowding and poor access to facilities such as working washing machines and showers facilitate the ongoing transmission of bacteria.


Read more: Five of the scariest antibiotic-resistant bacteria in the past five years


Antibiotic resistance and closing the gap

Health-care workers in remote clinics come from all across Australia and New Zealand, sometimes only for short stints. So it’s important they are educated about local antibiotic resistance rates and local treatment guidelines.

Similarly, doctors in remote clinics need to be able to access real-time local antibiotic resistance rates. Pleasingly, an online atlas for health practitioners of antibiotic resistance rates across northern Australia, called “HOTspots”, is currently being set up.


Read more: To close the health gap, we need programs that work. Here are three of them


Addressing antibiotic resistance in remote Indigenous communities must be part of the ongoing effort to close the gap in health outcomes between Indigenous and non-Indigenous Australians.

Inclusion of remote Indigenous populations as a priority in the National AMR Strategy is essential. These groups are not mentioned in the current strategy (2015-2019) but we are hopeful they will be included in the new strategy, to be released soon.

Implementing the the National AMR Strategy for remote living Indigenous Australians must be a high priority to ensure antibiotics are available to treat infections among this already vulnerable section of our population.

Dr Lorraine Anderson, medical director at Kimberley Aboriginal Medical Services in Broome, Western Australia, contributed to this article.

Asha Bowen receives funding from the National Health and Medical Research Council and the Western Australia Health Department.

Steven Tong receives funding from the National Health and Medical Research Council.

Authors: Asha Bowen, Head, Skin Health, Telethon Kids Institute

Read more http://theconversation.com/antibiotic-resistance-is-an-even-greater-challenge-in-remote-indigenous-communities-121696

All You Need to Know About Trenchless Technology

For many years, the traditional sewerage lines and pipe developments were not enough due to the long wait and cracking. The traditional sewer pipe repairs involved cracking the earth to find the par...

News Company - avatar News Company

Before we rush to rebuild after fires, we need to think about where and how

A primary school in East Gippsland was burnt down in the current bushfire crisis. While Premier Daniel Andrews immediately committed to rebuilding the school as it was, media reported the local CFA ca...

Mark Maund, PhD Candidate, School of Architecture and Built Environment, University of Newcastle - avatar Mark Maund, PhD Candidate, School of Architecture and Built Environment, University of Newcastle

Australian sea lions are declining. Using drones to check their health can help us understand why

Australian sea lions (Neophoca cinerea) are one of the rarest pinnipeds in the world and they are declining. Jarrod Hodgson, CC BY-NDAustralian sea lions are in trouble. Their population has never rec...

Jarrod Hodgson, PhD Candidate, University of Adelaide - avatar Jarrod Hodgson, PhD Candidate, University of Adelaide

With costs approaching $100 billion, the fires are Australia's costliest natural disaster

It’s hard to estimate the eventual economic cost of Australia’s 2019-20 megafires, partly because they are still underway, and partly because it is hard to know the cost to attribute to de...

Paul Read, Climate Criminologist & Senior Instructor/Lecturer, Faculty of Medicine, Monash University - avatar Paul Read, Climate Criminologist & Senior Instructor/Lecturer, Faculty of Medicine, Monash University

In cases of cardiac arrest, time is everything. Community responders can save lives

Cardiac arrest can occur with little or no warning in people who were previously healthy, including young people. From shutterstock.comEach year more than 24,000 Australians experience a sudden cardia...

Bill Lord, Adjunct Associate Professor, Monash University - avatar Bill Lord, Adjunct Associate Professor, Monash University

So the government gave sports grants to marginal seats. What happens now?

When Australians pay their income tax, they assume the money is going to areas of the community that need it, rather than being used by the government to shore up votes for the next election. This is...

Maria O'Sullivan, Senior Lecturer, Faculty of Law, and Deputy Director, Castan Centre for Human Rights Law, Monash University - avatar Maria O'Sullivan, Senior Lecturer, Faculty of Law, and Deputy Director, Castan Centre for Human Rights Law, Monash University

The Olympics have always been a platform for protest. Banning hand gestures and kneeling ignores their history

It is the year of the Tokyo Olympics, and the International Olympic Committee was quickly out of the blocks with new guidelines regarding athlete protests. The IOC is worried the biggest stories of...

David Rowe, Emeritus Professor of Cultural Research, Institute for Culture and Society, Western Sydney University - avatar David Rowe, Emeritus Professor of Cultural Research, Institute for Culture and Society, Western Sydney University

Where Can You Get Weed By Ordering It Online?

Nowadays, everyone wants to get their hands on some weed. Marijuana has become legalized in a lot of countries worldwide. People wait in lines for days to buy some. You couldn’t have imagined that...

News Company - avatar News Company

Hidden women of history: Catherine Hay Thomson, the Australian undercover journalist who went inside asylums and hospitals

Catherine Hay Thomson went undercover as an assistant nurse for her series on conditions at Melbourne Hospital. A. J. Campbell Collection/National Library of AustraliaIn this series, we look at under...

Kerrie Davies, Lecturer, School of the Arts & Media, UNSW - avatar Kerrie Davies, Lecturer, School of the Arts & Media, UNSW

Sick and Tired of Your Dead End Job? Try Teaching!

Tired of the same old grind at the office? Want an opportunity to impact lives both in your community and around the world? Do you love to travel and have new experiences? Teaching English is the perfect job for you! All you need is a willingness to ...

News Company - avatar News Company

The Impact of an Aging Population in Australia

There’s an issue on the horizon that Australia needs to prepare for. The portion of elderly citizens that make up the country’s overall population is increasing, and we might not have the infrastructure in place to support this. Australians h...

News Company - avatar News Company