Population-Based Community Prevalence of Methicillin-Resistant Staphylococcus aureus in the Urban Poor of San Francisco
Abstract
The study objective was to determine the prevalence and risk factors for nasal colonization with Staphylococcus aureus and methicillin resistance among the urban poor and to compare antibiotic resistance and genetic similarity to concurrently collected clinical isolates of methicillin-resistant S. aureus (MRSA). A population-based community sample of 833 homeless and marginally housed adults were cultured and compared with 363 clinical isolates of MRSA; 22.8% of the urban poor were colonized with S. aureus. Of S. aureus isolates, 12.0% were methicillin resistant. Overall prevalence of MRSA was 2.8%. Significant multivariate risk factors for MRSA were injection drug use (odds ratio [OR], 9.7), prior endocarditis (OR, 4.1), and prior hospitalization within 1 year (OR, 2.4). Resistance to antimicrobials other than β-lactams was uncommon. Only 2 individuals (0.24%) with MRSA had no known risk factors. A total of 22 of 23 community MRSA genotypically matched clinical MRSA isolates, with 15 of 23 isolates identical to MRSA clones endemic among hospitalized patients.
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In other research, IDU was strongly linked to MRSA SSTI in homeless individuals, but this association was not found in 2 ED-based studies.
“In other research, IDU was strongly linked to MRSA SSTI in homeless individuals, 7 but this association was not found in 2 ED-based studies. 8,15”
From Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department (2009) · cites this paper as [7]
Previous studies, mostly in US or European settings, have identified HIV infection and injection drug use as risk factors for MRSA SSTI, as well as incarceration and participation in contact sports.
“Previous studies (mostly in US or European settings) have identified HIV infection and injection drug use (IDU) as risk factors, 7 as well as incarceration, 10 and participation in contact sports, such as wrestling. 11”
From Prevalence of and risk factors for methicillin-resistant Staphylococcus aureus skin and soft tissue infection in a Canadian emergency department (2009) · cites this paper as [7]
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- Authors
- Charlebois, E. D., Bangsberg, D. R., Moss, N. J., Moore, M. R., Moss, A. R., Chambers, H. F., & Perdreau-Remington, F.
- Affiliations
- San Francisco General Hospital (US)
- University of California, San Francisco (US)
- Department of Medicine, Epidemiology and Prevention Interventions Center, Division of Infectious Diseases, San Francisco General Hospital 1 , San Francisco
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2002-02-01
- Volume
- 34
- Issue
- 4
- Pages
- 425-433
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2098172533
- Cited by
- 245
- References
- 37
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 7 · 2018: 2 · 2017: 3 · 2016: 3 · 2015: 10 · 2014: 8 · 2013: 5 · 2012: 7
- FWCI
- 16.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r03ai043959-02)
- National Institute of Mental Health (R01MH054907, R01 MH 54907)
- National Institute of Allergy and Infectious Diseases (R01AI046610, AI43959, AI 46610)
- 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, nasal carriage, MRSA prevalence, urban poverty, homelessness, intravenous drug use, endocarditis, prior hospitalization, antibiotic resistance, MRSA genotyping, community-acquired MRSA, San Francisco
- MeSH terms
- Adolescent, Adult, Aged, Anti-Bacterial Agents, Female, Genotype, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Risk Factors, San Francisco, Staphylococcal Infections, Staphylococcus aureus, Urban Health, Urban Population, Substance Abuse, Intravenous, Prevalence, Methicillin Resistance
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