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Racial Disparities in Invasive Methicillin-resistant Staphylococcus aureus Infections, 2005-2014

Nicole Gualandi1, Yi Mu1, Wendy M Bamberg2

  • 1Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|April 17, 2018
PubMed
Abstract

Insights

Racial disparities in methicillin-resistant Staphylococcus aureus (MRSA) infections persist despite overall decreases in healthcare-associated MRSA. Targeted interventions are needed to address these persistent racial inequities in MRSA rates.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Health Disparities

Background:

  • Limited understanding of the relationship between racial disparities and antimicrobial-resistant infections like MRSA.
  • Healthcare-associated infections (HAIs) and antimicrobial resistance are significant public health concerns.
  • Investigating racial disparities in MRSA trends is crucial for targeted public health strategies.

Purpose of the Study:

  • To determine if reductions in invasive methicillin-resistant Staphylococcus aureus (MRSA) incidence affected racial disparities.
  • To analyze trends in hospital-onset (HO), healthcare-associated community-onset (HACO), and community-associated (CA) MRSA rates by race.
  • To evaluate racial differences in MRSA rates among chronic dialysis patients.

Main Methods:

  • Analysis of Emerging Infections Program surveillance data from 2005-2014 across 9 US states.
  • Classification of MRSA cases into HO, HACO, and CA categories based on culture timing and patient history.
  • Use of negative binomial regression to assess the adjusted rate ratio (aRR) of MRSA in black patients compared to white patients, controlling for covariates.

Main Results:

  • Invasive HO and HACO MRSA rates decreased from 2005-2014, while CA MRSA rates did not.
  • Black patients consistently had higher rates of HO, HACO, and CA MRSA compared to white patients.
  • Higher HACO MRSA rates among black dialysis patients decreased but remained significant, despite an overall decrease in invasive MRSA among dialysis patients.

Conclusions:

  • Reductions in healthcare-associated MRSA infections have not diminished racial disparities.
  • Persistent racial differences in MRSA rates were observed across all case classifications and did not change over time.
  • Further research into the root causes of these disparities is essential for developing effective prevention interventions.

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