Area Deprivation as a Risk Factor for Methicillin-resistant Staphylococcus aureus Infection in Pediatric Cystic...

Area of Science:

• Pediatric pulmonology
• Infectious disease epidemiology
• Social determinants of health

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) rates have tripled in US cystic fibrosis (CF) patients over two decades.
• Clinical risk factors for MRSA in CF include healthcare exposure, Pseudomonas aeruginosa, and CF-related diabetes.
• Area-level socio-environmental exposures have not been previously evaluated as a risk factor.

Purpose of the Study:

• To explore the association between area-level deprivation and MRSA prevalence in pediatric CF patients.
• To investigate the impact of neighborhood socioeconomic factors on MRSA infection risk.

Main Methods:

• Geocoding of patient residential addresses linked to Area Deprivation Index and Rural-Urban Commuting Area scores.
• Logistic regression analysis adjusted for sociodemographic covariates, clinical risk factors, and clustering.
• Inclusion of 231 pediatric CF patients from a single center in the Southeastern US.

Main Results:

• MRSA was present in 44% of the pediatric CF patient cohort.
• Higher area-level deprivation correlated with rural residence, lower parental education, and reduced household income.
• Neighborhood deprivation was associated with a more than twofold increase in the odds of MRSA infection (OR 2.26, P < 0.05) after full adjustment.

Conclusions:

• Neighborhood deprivation emerges as a significant risk factor for MRSA in pediatric CF patients.
• Community-level socioeconomic factors, such as deprivation, double the odds of MRSA infection.
• Prevention strategies and treatment plans for MRSA in pediatric CF should incorporate community-level socioeconomic risk factors.