Racial Disparities in Invasive Methicillin-resistant Staphylococcus aureus Infections, 2005–2014

Autor: Lee H. Harrison, Yi Mu, Wendy Bamberg, Isaac See, Joelle Nadle, Mariana McDonald, John M. Townes, William Schaffner, Ghinwa Dumyati, Sue Petit, Nicole Gualandi, Susan M. Ray, Lindsey Lesher
Rok vydání: 2018
Předmět:
Male
medicine.medical_treatment
Rate ratio
medicine.disease_cause
01 natural sciences
0302 clinical medicine
Risk Factors
030212 general & internal medicine
Young adult
Child
Cross Infection
Incidence
Incidence (epidemiology)
Absolute risk reduction
Middle Aged
Staphylococcal Infections
Race Factors
Community-Acquired Infections
Hospitalization
Infectious Diseases
Child
Preschool
Epidemiological Monitoring
Regression Analysis
Female
Hemodialysis
Adult
Methicillin-Resistant Staphylococcus aureus
Microbiology (medical)
medicine.medical_specialty
Adolescent
Black People
Staphylococcal infections
White People
Young Adult
03 medical and health sciences
Internal medicine
medicine
Humans
0101 mathematics
Dialysis
Aged
Models
Statistical
business.industry
010102 general mathematics
Infant
Health Status Disparities
medicine.disease
Long-Term Care
Methicillin-resistant Staphylococcus aureus
United States
business
Zdroj: Clinical Infectious Diseases. 67:1175-1181
ISSN: 1537-6591
1058-4838
2005-2014
DOI: 10.1093/cid/ciy277
Popis: Background Despite substantial attention to the individual topics, little is known about the relationship between racial disparities and antimicrobial-resistant and/or healthcare-associated infection trends, such as for methicillin-resistant Staphylococcus aureus (MRSA). Methods We analyzed Emerging Infections Program 2005-2014 surveillance data (9 US states) to determine whether reductions in invasive MRSA incidence (isolated from normally sterile body sites) affected racial disparities in rates. Case classification included hospital-onset (HO, culture >3 days after admission), healthcare-associated community onset (HACO, culture ≤3 days after admission and dialysis, hospitalization, surgery, or long-term care residence within 1 year prior), or community-associated (CA, all others). Negative binomial regression models were used to evaluate the adjusted rate ratio (aRR) of MRSA in black patients (vs in white patients) controlling for age, sex, and temporal trends. Results During 2005-2014, invasive HO and HACO (but not CA) MRSA rates decreased. Despite this, blacks had higher rates for HO (aRR, 3.20; 95% confidence interval [CI], 2.35-4.35), HACO (aRR, 3.84; 95% CI, 2.94-5.01), and CA (aRR, 2.78; 95% CI, 2.30-3.37) MRSA. Limiting the analysis to chronic dialysis patients reduced, but did not eliminate, the higher HACO MRSA rates among blacks (aRR, 1.83; 95% CI, 1.72-1.96), even though invasive MRSA rates among dialysis patients decreased during 2005-2014. These racial differences did not change over time. Conclusions Previous reductions in healthcare-associated MRSA infections have not affected racial disparities in MRSA rates. Improved understanding of the underlying causes of these differences is needed to develop effective prevention interventions that reduce racial disparities in MRSA infections.
Databáze: OpenAIRE
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