Replacement of HA-MRSA by CA-MRSA Infections at an Academic Medical Center in the Midwestern United States, 2004-5 to 2008

Published on Apr 22, 2014in PLOS ONE3.24
· DOI :10.1371/JOURNAL.PONE.0092760
Michael Z. David32
Estimated H-index: 32
(U of C: University of Chicago),
Adriana Cadilla3
Estimated H-index: 3
(U of C: University of Chicago)
+ 1 AuthorsRobert S. Daum57
Estimated H-index: 57
(U of C: University of Chicago)
Sources
Abstract
We noted anecdotally that infections designated as health care-associated (HA-) MRSA by epidemiologic criteria seemed to be decreasing in incidence at the University of Chicago Medical Center (UCMC) after 2004. We compared MRSA patients seen at any site of clinical care at UCMC and the isolates that caused their infections in 2004-5 (n = 545) with those in 2008 (n = 135). The percent of patients with MRSA infections cultured > 2 days after hospital admission decreased from 19.5% in 2004-5 to 7.4% in 2008 (p = 0.001). The percent in 2004-5 compared with 2008 who had a hospitalization (49.1% to 26.7%, p = 0.001) or surgery (43.0% to 14.1%, p<0.001) in the previous year decreased. In 2008 a greater percent of patients was seen in the emergency department (23.1% vs. 39.3%) and a smaller percent both in intensive care units (15.6% vs. 6.7%) and in other inpatient units (40.7% vs. 32.6%) (p<0.001). The percent of patients with CA-MRSA infections by the CDC epidemiologic criteria increased from 36.5% in 2004-5 to 62.2% in 2008 (p<0.001). The percent of MRSA isolates sharing genetic characteristics of USA100 decreased from 27.9% (152/545) to 12.6% (17/135), while the percent with CA-MRSA (USA300) characteristics increased from 53.2% (290/545) to 66.7% (90/135). The percent of infections that were invasive did not change significantly. Our data suggest that HA-MRSA infections, both by epidemiologic and microbiologic criteria, relative to CA-MRSA, decreased between 2004-5 and 2008 at UCMC.
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References22
Newest
#1Amanda M. Farr (Thomson Reuters)H-Index: 2
#2Brandon Aden (Cornell University)H-Index: 8
Last. Melissa A. Marx (CDC: Centers for Disease Control and Prevention)H-Index: 7
view all 5 authors...
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Source
#1G. Thomas Ray (KP: Kaiser Permanente)H-Index: 39
#2Jose A. Suaya (GSK: GlaxoSmithKline)H-Index: 27
Last. Roger BaxterH-Index: 51
view all 3 authors...
Infections due to Staphylococcus aureus present a significant health problem in the United States. Between 1990 and 2005, there was a dramatic increase in community-associated methicillin-resistant S. aureus (MRSA), but recent reports suggest that MRSA may be declining. We retrospectively identified S. aureus isolates (n = 133,450) that were obtained from patients in a large integrated health plan between 1 January 1998 and 31 December 2009. Trends over time in MRSA were analyzed, and demographi...
Source
#1Aisling R. Caffrey (URI: University of Rhode Island)H-Index: 17
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Source
#1Munirih QuallsH-Index: 2
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view all 6 authors...
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Source
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Source
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Source
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Source
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Source
Source
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Source
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