Cited by 155Antimicrobial Resistance in StaphylococcusAntibiotic Use and ResistanceInfection Control in Healthcare

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The Changing Epidemiology of Methicillin-Resistant Staphylococcus aureus in the United States: A National Observational Study

Klein, Eili Y., Sun, Lova, Smith, David L., Laxminarayan, Ramanan·2013·American Journal of Epidemiology

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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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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
ORCID: Klein, Eili Y.
Sun, Lova
Smith, David L.
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
DOI: 10.1093/aje/kws273
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
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
Health Sciences › Medicine › Infectious Diseases › 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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The Changing Epidemiology of Methicillin-Resistant Staphylococcus aureus in the United States: A National Observational Study

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