National Burden of Invasive Methicillin-Resistant Staphylococcus aureus Infections, United States, 2011
Open accessAbstract
IMPORTANCE: Estimating the US burden of methicillin-resistant Staphylococcus aureus (MRSA) infections is important for planning and tracking success of prevention strategies. OBJECTIVE: To describe updated national estimates and characteristics of health care- and community-associated invasive methicillin-resistant Staphylococcus aureus (MRSA) infections in 2011. DESIGN, SETTING, AND PARTICIPANTS: Active laboratory-based case finding identified MRSA cultures in 9 US metropolitan areas from 2005 through 2011. Invasive infections (MRSA cultured from normally sterile body sites) were classified as health care-associated community-onset (HACO) infections (cultured ≤ 3 days after admission and/or prior year dialysis, hospitalization, surgery, long-term care residence, or central vascular catheter presence ≤ 2 days before culture); hospital-onset infections (cultured >3 days after admission); or community-associated infections if no other criteria were met. National estimates were adjusted using US census and US Renal Data System data. MAIN OUTCOMES AND MEASURES: National estimates of invasive HACO, hospital-onset, and community-associated MRSA infections using US census and US Renal Data System data as the denominator. RESULTS: An estimated 80,461 (95% CI, 69,515-93,914) invasive MRSA infections occurred nationally in 2011. Of these, 48,353 (95% CI, 40,195-58,642) were HACO infections; 14,156 (95% CI, 10,096-20,440) were hospital-onset infections; and 16,560 (95% CI, 12,806-21,811) were community-associated infections. Since 2005, adjusted national estimated incidence rates decreased among HACO infections by 27.7% and hospital-onset infections decreased by 54.2%; community-associated infections decreased by only 5.0%. Among recently hospitalized community-onset (nondialysis) infections, 64% occurred 3 months or less after discharge, and 32% of these were admitted from long-term care facilities. CONCLUSIONS AND RELEVANCE: An estimated 30,800 fewer invasive MRSA infections occurred in the United States in 2011 compared with 2005; in 2011 fewer infections occurred among patients during hospitalization than among persons in the community without recent health care exposures. Effective strategies for preventing infections outside acute care settings will have the greatest impact on further reducing invasive MRSA infections nationally.
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Because the populations under surveillance in the 9 EIP sites are diverse, EIP findings can and have been used to extrapolate to national estimates of other infections.
“Furthermore, because the populations under surveillance in the 9 sites are diverse (by age distribution, race, urban/rural, and other factors), EIP findings can and have been used to extrapolate to national estimates of other infections [33,34].”
From Burden of Candidemia in the United States, 2017 (2020) · cites this paper as [33]
The Discussion describes diverse populations in several metropolitan surveillance areas, and Methods > Statistical Analysis explains how EIP-ABCs data were extrapolated to national estimates of invasive MRSA. The paper does not establish that the sites are diverse by urban/rural status or that EIP findings have been used to estimate other infections nationally. It also cautions that the sites were not randomly selected to be representative. (LLM, conf=0.87)
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- Authors
- Dantes, R.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Dantes, Raymund
- ORCID
- Dantes, Raymund
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2013-09-16
- Volume
- 173
- Issue
- 21
- Pages
- 1970-8
- ISSN
- 2168-6106 (ISSN-L)
- PMC
- PMC10887428
- OpenAlex
- W2137893923
- Cited by
- 452
- References
- 3
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 14 · 2023: 18 · 2022: 14 · 2021: 17 · 2020: 37 · 2019: 54 · 2018: 57 · 2017: 59 · 2016: 59 · 2015: 68 · 2014: 35 · 2013: 4
- FWCI
- 40.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Keywords
- methicillin-resistant Staphylococcus aureus, invasive MRSA infections, nosocomial infections, community-associated infections, hospital-onset infection, long-term care facilities, dialysis-associated infection, infection control, United States, incidence trends, laboratory surveillance, active case finding, dialysis patients
- MeSH terms
- Adolescent, Adult, Aged, Child, Child, Preschool, Cross Infection, Female, Renal Dialysis, Hospitalization, Humans, Infant, Long-Term Care, Male, Middle Aged, Nursing Homes, Risk Factors, Staphylococcal Infections, United States, Cost of Illness, Community-Acquired Infections, Methicillin-Resistant Staphylococcus aureus
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