{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:04:52Z","timestamp":1785229492678,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Methicillin\u2010resistant\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (MRSA) bloodstream infections (BSIs) cause significant morbidity and mortality. In Australia's Northern Territory (NT), MRSA BSI prevalence is disproportionately high. Vancomycin remains standard therapy despite toxicity and complex monitoring requirements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate demographics, clinical management and outcomes of patients with MRSA BSI in the NT, with a focus on health inequities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multi\u2010centre retrospective observational study analysed MRSA BSI episodes in hospitalised adults between 2017 and 2022 at the Royal Darwin and Alice Springs Hospitals. Key data were extracted from electronic medical records. Composite treatment failure was defined as follows: outcome of all\u2010cause 90\u2010day mortality, persistent bacteraemia (&gt;7\u2009days) or 90 day relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 182 identified episodes, MRSA accounted for 40% of all\n                      <jats:italic>S. aureus<\/jats:italic>\n                      BSIs. First Nations Australians were disproportionately affected, representing 69% of episodes, with an incidence rate 3.3 times higher than non\u2010Indigenous residents. The composite treatment failure rate was 18%, and 90\u2010day mortality was 13%. Age \u2265\u200950\u2009years was the only independent variable associated with treatment failure. Notably, 19% of patients required an antimicrobial switch from vancomycin, frequently due to adverse drug reactions. Vancomycin minimum inhibitory concentration (MIC) testing showed high discordance between VITEK2 and\n                      <jats:italic>E<\/jats:italic>\n                      \u2010Test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>MRSA bloodstream infections remain a significant challenge in the NT, largely due to social and structural factors disproportionately affecting First Nations Australians. While strategies to prevent invasive bloodstream infections should be prioritised, the high incidence of vancomycin\u2010related adverse events and MIC discordance underscores the urgent need for stable, effective oral antimicrobial alternatives and culturally safe, community\u2010led prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.70472","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T13:04:22Z","timestamp":1779541462000},"page":"1200-1208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Methicillin\u2010resistant\n                    <scp>\n                      <i>Staphylococcus aureus<\/i>\n                    <\/scp>\n                    bloodstream infections in the Northern Territory of Australia 2017\u20132022"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0541-4065","authenticated-orcid":false,"given":"Sara","family":"Davison","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"},{"name":"Department of Infectious Diseases and Microbiology Barts Health Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Bryce","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"},{"name":"Department of General Medicine Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Alice Springs Hospital  Alice Springs Northern Territory Australia"},{"name":"Department of Infectious Diseases Barwon Health  Geelong Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Baird","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"},{"name":"Territory Pathology  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ewin","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahid","family":"Ullah","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health Flinders University  Adelaide South Australia Australia"},{"name":"Flinders Health and Medical Research Institute Flinders University  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonja","family":"Janson","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Royal Darwin Hospital  Darwin Northern Territory Australia"},{"name":"Global &amp; Tropical Health Division Menzies School of Health Research and Charles Darwin University  Darwin Northwest Territories Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danny","family":"Tsai","sequence":"additional","affiliation":[{"name":"Flinders Health and Medical Research Institute Flinders University  Adelaide South Australia Australia"},{"name":"Pharmacy Department Alice Springs Hospital  Alice Springs Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1228"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.05022-11"},{"key":"e_1_2_12_4_1","first-page":"2022","volume-title":"Australian Group on Antimicrobial Resistance and Australian Commission on Safety and Quality in Health Care on Antimicrobial Resistance Surveillance Outcomes Programs: 2021 Report","author":"Coombs G","year":"2022"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51897"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2011.02449.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1086\/598218"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piu013"},{"key":"e_1_2_12_9_1","unstructured":"Australian Institute of Health and Welfare.A Determinants of health for Indigenous Australians (Internet). 2022. 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