Racial Disparities in Invasive Methicillin-resistant Staphylococcus aureus Infections, 2005–2014
Open accessAbstract
Background: Despite substantial attention to the individual topics, little is known about the relationship between racial disparities and antimicrobial-resistant and/or healthcare-associated infection trends, such as for methicillin-resistant Staphylococcus aureus (MRSA). Methods: We analyzed Emerging Infections Program 2005-2014 surveillance data (9 US states) to determine whether reductions in invasive MRSA incidence (isolated from normally sterile body sites) affected racial disparities in rates. Case classification included hospital-onset (HO, culture >3 days after admission), healthcare-associated community onset (HACO, culture ≤3 days after admission and dialysis, hospitalization, surgery, or long-term care residence within 1 year prior), or community-associated (CA, all others). Negative binomial regression models were used to evaluate the adjusted rate ratio (aRR) of MRSA in black patients (vs in white patients) controlling for age, sex, and temporal trends. Results: During 2005-2014, invasive HO and HACO (but not CA) MRSA rates decreased. Despite this, blacks had higher rates for HO (aRR, 3.20; 95% confidence interval [CI], 2.35-4.35), HACO (aRR, 3.84; 95% CI, 2.94-5.01), and CA (aRR, 2.78; 95% CI, 2.30-3.37) MRSA. Limiting the analysis to chronic dialysis patients reduced, but did not eliminate, the higher HACO MRSA rates among blacks (aRR, 1.83; 95% CI, 1.72-1.96), even though invasive MRSA rates among dialysis patients decreased during 2005-2014. These racial differences did not change over time. Conclusions: Previous reductions in healthcare-associated MRSA infections have not affected racial disparities in MRSA rates. Improved understanding of the underlying causes of these differences is needed to develop effective prevention interventions that reduce racial disparities in MRSA infections.
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Self-citation
- Authors
- Gualandi, N., Mu, Y., Bamberg, W. M., Dumyati, G., Harrison, L. H., Lesher, L., Nadle, J., Petit, S., Ray, S. M., Schaffner, W., Townes, J., McDonald, M., & See, I.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Colorado Department of Public Health and Environment (US)
- University of Rochester Medicine (US)
- Johns Hopkins University (US)
- Minnesota Department of Health (US)
- California Emerging Infections Program, Oakland
- Connecticut Department of Public Health (US)
- Emory University (US)
- Vanderbilt University Medical Center (US)
- Oregon Health & Science University (US)
- Corresponding author
- Gualandi, Nicole
- ORCID
- Gualandi, Nicole
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-04-05
- Volume
- 67
- Issue
- 8
- Pages
- 1175-1181
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC6232852
- OpenAlex
- W2582489268
- Semantic Scholar
- 2971f60c5dbd2fb0882606dc6ffc09fd211d2238
- Cited by
- 60
- References
- 17
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 12 · 2023: 13 · 2022: 4 · 2021: 2 · 2020: 8 · 2019: 2 · 2017: 1
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- Locations
- Clinical Infectious Diseases (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- CSTE Annual Conference
- Funders
- CDC Emerging Infections Program (U50CK000201, U50CK000194, U50CK000195, U50CK000196, U50CK000203, U50CK000204, U50CK000199, U50CK000197, U50CK000198)
- 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, racial disparities, Black patients, nosocomial infections, community-acquired MRSA, hospital-onset infection, chronic dialysis, antimicrobial resistance
- MeSH terms
- Race Factors, Adolescent, Adult, Aged, Black or African American, Child, Child, Preschool, Cross Infection, Female, Hospitalization, Humans, Infant, Long-Term Care, Male, Middle Aged, Regression Analysis, Risk Factors, Staphylococcal Infections, United States, Models, Statistical, Incidence, Community-Acquired Infections, Black People, White People, Health Status Disparities, Methicillin-Resistant Staphylococcus aureus, Young Adult, Epidemiological Monitoring
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