The Changing Epidemiology of Methicillin-Resistant Staphylococcus aureus in the United States: A National Observational Study
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) can cause major illness and death and impose serious economic costs on patients and hospitals. Community-associated MRSA (CA-MRSA) is a growing problem in US hospitals, which are already dealing with high levels of hospital-associated MRSA (HA-MRSA), but little is known about how patient age and seasonal differences in the incidence of these 2 forms of MRSA affect the epidemic. By using national data on hospitalizations and antibiotic resistance, we estimated the magnitude and trends in annual S. aureus and MRSA hospitalization rates from 2005-2009 by patient age, infection type, and resistance phenotype (CA-MRSA vs. HA-MRSA). Although no statistically significant increase in the hospitalization rate was seen over the study period, the total number of infections increased. In 2009, there were an estimated 463,017 (95% confidence interval: 441,595, 484,439) MRSA-related hospitalizations at a rate of 11.74 (95% confidence interval: 11.20, 12.28) per 1,000 hospitalizations. We observed significant differences in infection type by age, with HA-MRSA-related hospitalizations being more common in older individuals. We also noted significant seasonality in incidence, particularly in children, with CA-MRSA peaking in the late summer and HA-MRSA peaking in the winter, which may be caused by seasonal shifts in antibiotic prescribing patterns.
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There was not enough data to draw any inferences regarding temporal changes in the etiology of coinfecting pathogens.
“However, although there have been significant increases in the incidence of MRSA infections in the last decade, particularly community‐associated MRSA (CA‐MRSA),64 there was not enough data to draw any inferences regarding temporal changes in the etiology of coinfecting pathogens.”
From The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. (2016) · cites this paper as [64]
Approximately 50% of hospital S. aureus isolates are MRSA.
“Given that over 25% of identified isolates were S. aureus, and that approximately 50% of hospital S. aureus isolates are MRSA,64 our study supports IDSA recommendations for empiric coverage of CA‐MRSA in influenza‐related pneumonia patients.63”
From The frequency of influenza and bacterial coinfection: a systematic review and meta-analysis. (2016) · cites this paper as [64]
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- Authors
- Klein, E. Y., Sun, L., Smith, D. L., & Laxminarayan, R.
- Affiliations
- Princeton University (US)
- Center for Disease Dynamics, Economics & Policy (US)
- Corresponding author
- Laxminarayan, Ramanan
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-02-28
- Volume
- 177
- Issue
- 7
- Pages
- 666-674
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2104267283
- Cited by
- 155
- References
- 38
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 4 · 2022: 8 · 2021: 7 · 2020: 6 · 2019: 16 · 2018: 16 · 2017: 22 · 2016: 17 · 2015: 14 · 2014: 16 · 2013: 13 · 2012: 2
- FWCI
- 14.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation
- Princeton University
- Johns Hopkins University
- Princeton Environmental Institute, Princeton University
- Emerging Pathogens Institute, University of Florida
- 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, community-acquired MRSA, hospital-acquired MRSA, seasonal variation, age differences in infection, antibiotic resistance, antibiotic prescribing patterns
- MeSH terms
- Adult, Aged, Anti-Bacterial Agents, Cross Infection, Hospitalization, Humans, Middle Aged, Phenotype, Seasons, Staphylococcal Infections, United States, Incidence, Age Distribution, Community-Acquired Infections, Methicillin-Resistant Staphylococcus aureus
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