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Trends in Hospitalization for Community-Associated Methicillin-Resistant Staphylococcus aureus in New York City, 1997–2006: Data from New York State's Statewide Planning and Research Cooperative System

Published online by Cambridge University Press:  02 January 2015

Amanda M. Farr ,
Brandon Aden ,
Don Weiss ,
Denis Nash  and
Melissa A. Marx
Amanda M. Farr*
Affiliation:
Custom Data Analytics, Thomson Reuters, Washington, DC
Brandon Aden
Affiliation:
Department of Public Health, Weill Cornell Medical College, New York, New York
Don Weiss
Affiliation:
Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York
Denis Nash
Affiliation:
Epidemiology and Biostatistics Program, Hunter College School of Public Health, New York, New York
Melissa A. Marx
Affiliation:
Global AIDS Program, Centers for Disease Control and Prevention, Lukasa, Zambia
*
420 Whitney Avenue, Apt 12, New Haven, CT 06511 ([email protected])
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Abstract

Objective.

To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections.

Design.

Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006.

Patients.

All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities.

Methods.

We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression.

Results.

Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization.

Conclusions.

The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 7 , July 2012 , pp. 725 - 731
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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References

1. Barber, M. Naturally occurring methicillin-resistant staphylococci. J Gen Microbiol 1964;35:183–190.Google Scholar
2. Saravolatz, L, Markowitz, N. Methicillin-resistant Staphylococcus aureus: epidemiologic observations during a community-acquired outbreak. Ann Int Med 1982;96(1):11–16.Google Scholar
3. Herold, B, Immergluck, L, Marañan, MC, et al. Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk factor. JAMA 1998;279: 593–598.CrossRefGoogle Scholar
4. Como-Sabetti, K, Harriman, KH, Buck, JM, Glennen, A, Boxrud, DJ, Lynfield, R. Community-associated methicillin-resistant Staphylococcus aureus: trends in case and isolate characteristics from six years of prospective surveillance. Public Health Rep 2009;124:427–435.Google Scholar
5. Kaplan, SL, Hulten, KG, Gonzalez, BE, et al. Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clin Infect Dis 2005;40:1785–1791.CrossRefGoogle ScholarPubMed
6. Begier, EM, Frenette, K, Barrett, NL, et al. A high-morbidity outbreak of methicillin-resistant Staphylococcus aureus among players on a college football team, facilitated by cosmetic body shaving and turf burns. Clin Infect Dis 2004;39:1446–1453.Google Scholar
7. Lowy, FD, Aiello, AE, Bhat, M, et al. Staphylococcus aureus colonization and infection in New York State prisons. J Infect Dis 2007;196:911–918.CrossRefGoogle ScholarPubMed
8. Centers for Disease Control and Prevention. Public health dispatch: outbreaks of community-associated methicillin-resistant Staphylococcus aureus skin infections—Los Angeles County, California, 2002-2003. MMWR Morb Mortal Wkly Rep 2003;52:88.Google Scholar
9. Sztramko, R, Katz, K, Antoniou, T, et al. Community-associated methicillin-resistant Staphylococcus aureus infections in men who have sex with men: a case series. Can J Infect Dis Med Microbiol 2007;18:257–261.CrossRefGoogle ScholarPubMed
10. Statewide Planning and Research Cooperative System (SPARCS). New York State website, http://www.health.ny.gov/statistics/spares/. Published 2009. Accessed June 22, 2009.Google Scholar
11. Frei, CR, Makos, BR, Daniels, KR, Oramasionwu, CU. Emergence of community-acquired methicillin-resistant Staphylococcus aureus skin and soft tissue infections as a common cause of hospitalization in United States children. J Pediatr Surg 2010;45: 1967–1974.CrossRefGoogle ScholarPubMed
12. Gerber, JS, Coffin, SE, Smathers, SA, Zaoutis, TE. Trends in the incidence of methicillin-resistant Staphylococcus aureus infection in children's hospitals in the United States. Clin Infect Dis 2009; 491:65–71.CrossRefGoogle Scholar
13. Popovic, JR. 1999 National hospital discharge survey: annual summary with detailed diagnosis and procedure data. Vital Health Stat 13 2001;151:i-v, 1–206.Google Scholar
14. Neighborhood population estimates. New York City Department of Health and Mental Hygiene website, http://www.nyc.gov/html/doh/html/episrv/popest_methods.shtml#5. Published 2010. Accessed February 14, 2010.Google Scholar
15. Klevens, RM, Morrison, MA, Nadle, J, et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007;298:1763–1771.CrossRefGoogle ScholarPubMed
16. Fridkin, S, Hageman, J, Morrison, M, et al. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med 2005;352:1436–1444.Google Scholar
17. Olson, E, Van Wye, G, Kerker, B, Thorpe, L, Frieden, T. Take Care Southeast Bronx. New York City Department of Health and Mental Hygiene website, http://www.nyc.gov/html/doh/downloads/pdf/data/2006chp-104.pdf. Published 2006. Accessed September 1, 2009.Google Scholar
18. Epiquery: NYC interactive health data system—community health survey, 2006. New York City website, http://nyc.gov/health/epiquery. Published 2009. Accessed August 24, 2009.Google Scholar
19. Young, DM, Harris, HW, Charlebois, ED, et al. An epidemic of methicillin-resistant Staphylococcus aureus soft tissue infections among medically underserved patients. Arch Surg 2004; 139: 947–951; discussion, 951-953.Google Scholar
20. Frazee, BW, Lynn, J, Charlebois, ED, Lambert, L, Lowery, D, Perdreau-Remington, F. High prevalence of methicillin-resistant Staphylococcus aureus in emergency department skin and soft tissue infections. Ann Emerg Med 2005;45:311–320.Google Scholar
21. Turabelidze, G, Lin, M, Wolkoff, B, Dodson, D, Gladbach, S, Zhu, BP. Personal hygiene and methicillin-resistant Staphylococcus aureus infection. Emerg Infect Dis 2006;12:422–427.Google Scholar
22. Nguyen, DM, Mascóla, L, Brancoft, E. Recurring methicillin-resistant Staphylococcus aureus infections in a football team. Emerg Infect Dis 2005;11:526–532.CrossRefGoogle Scholar
23. Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus among competitive sports participants—Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000-2003. MMWR Morb Mortal Wkly Rep 2003;52: 793–795.Google Scholar
24. Marx, MA, Cook, H, Rehana, Z, et al. Results of a case-control investigation of risk factors for CA-MRSA in New York City, 2005-2007. In: Final Program and Abstract Book of 2008 Annual Conference on Antimicrobial Resistance. Bethesda, MD; June 23-25, 2008. Abstract S7.Google Scholar
25. Diep, BA, Chambers, HF, Graber, CJ, et al. Emergence of multidrug-resistant, community-associated, methicillin-resistant Staphylococcus aureus clone USA300 in men who have sex with men. Ann Intern Med 2008;148:249–257.Google Scholar
26. Crum-Cianflone, NF, Burgi, AA, Hale, BR. Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus infections among HIV-infected persons. Int J STD AIDS 2007; 18:521–526.Google Scholar
27. Trinh, TT, Short, WR, Mermel, LA. Community-associated methicillin-resistant Staphylococcus aureus skin and soft-tissue infection in HIV-infected patients. J Int Assoc Physicians AIDS Care (Chic) 2009;8:176–180.Google Scholar
28. Mathews, WC, Caperna, JC, Barber, RE, et al. Incidence of and risk factors for clinically significant methicillin-resistant Staphylococcus aureus infection in a cohort of HIV-infected adults. J Acquir Immune Defic Syndr 2005;40:155–160.CrossRefGoogle Scholar
29. Coldiron, BM, Bergstresser, PR. Prevalence and clinical spectrum of skin disease in patients infected with human immunodeficiency virus. Arch Dermatol 1989;125:357–361.CrossRefGoogle ScholarPubMed
30. Smith, KJ, Skelton, HG, Yeager, J, et al; Military Medical Consortium for the Advancement of Retroviral Research. Cutaneous findings in HIV-1-positive patients: a 42-month prospective study. J Am Acad Dermatol 1994;31:746–754.Google Scholar
31. Rubinstein, R, Genaro, AM, Motta, A, Cremaschi, G, Wald, MR. Impaired immune responses in streptozotocin-induced type I diabetes in mice: involvement of high glucose. Clin Exp Immunol 2008;154:235–246.Google Scholar
32. Shah, BR, Hux, JE. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care 2003;26:510–513.Google Scholar
33. Conversion Table of New ICD-9-CM Codes, October 2011. Centers for Disease Control and Prevention National Center for Health Statistics website. http://www.cdc.gov/nchs/data/icd9/CNVTB12.pdf Published 2011. Accessed January 6, 2012.Google Scholar
34. Byrd, KK, Holman, RC, Bruce, MG, et al. Methicillin-resistant Staphylococcus aureus-associated hospitalizations among the American Indian and Alaska Native population. Clin Infect Dis 2009;49:1009–1015.CrossRefGoogle ScholarPubMed
35. Herigon, JC, Hersh, AL, Gerber, JS, Zaoutis, TE, Newland, JG. Antibiotic management of Staphylococcus aureus infections in US children's hospitals, 1999-2008. Pediatrics 2011;125: e1294–e1300.Google Scholar
36. Caffrey, AR, Quilliam, BJ, LaPlante, KL. Comparative effectiveness of linezolid and vancomycin among a national cohort of patients infected with methicillin-resistant Staphylococcus aureus . Anrí-microb Agents Chemother 2010;54:4394–4400.Google Scholar
37. Schweizer, ML, Eber, MR, Laxminarayan, R, et al. Validity of ICD-9-CM coding for identifying incident methicillin-resistant Staphylococcus aureus (MRSA) infections: is MRSA infection coded as a chronic disease? Infect Control Hosp Epidemiol 2011;32: 148–154.Google Scholar
38. Schaefer, MK, Ellingson, K, Conover, C, et al. Evaluation of International Classification of Diseases, Ninth Revision, Clinical Modification codes for reporting methicillin-resistant Staphylococcus aureus infections at a hospital in Illinois. Infect Control Hosp Epidemiol 2010;31:463–468.Google Scholar