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Updated: Jan 18, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Area Deprivation as a Risk Factor for Methicillin-resistant Staphylococcus aureus Infection in Pediatric Cystic
Gabriela R Oates1,2, William T Harris1,2, Steven M Rowe1,2,3
1From the Department of Pediatrics.
Background:
In US cystic fibrosis (CF) patients, methicillin-resistant Staphylococcus aureus (MRSA) rates have tripled in the past 2 decades. Known clinical risk factors include exposure to a healthcare setting, Pseudomonas aeruginosa and CF-related diabetes. Area-level socio-environmental exposures have not been evaluated. We explored the association of area-level deprivation with MRSA prevalence in a pediatric CF Center in the Southeastern United States.
Methods:
Patients' residential addresses were geocoded and linked to a composite Area Deprivation Index and Rural-Urban Commuting Area scores. The association of MRSA with Area Deprivation Index and Rural-Urban Commuting Area scores was evaluated using logistic regression with robust standard errors adjusted for sociodemographic covariates (age, sex, race, mother's and father's education and household income), clinical risk factors (P. aeruginosa, CF-related diabetes, hospitalizations and number of clinic visits) and clustering.
Results:
The study included all pediatric patients (N = 231; mean age 12) at a single CF Center. MRSA was present in 44% of subjects. Higher area-level deprivation was correlated with rural residence, lack of parental college education and lower household income (P < 0.001 for each). In a multiple regression model fully adjusted for patient-level sociodemographic covariates, clinical risk factors and clustering, neighborhood deprivation was associated with more than 2-fold increase in the odds of having MRSA [OR 2.26 (1.14-4.45), P < 0.05].
Conclusions:
Neighborhood deprivation is a risk factor for MRSA in pediatric CF, doubling the odds of infection. Community-level socioeconomic risk factors should be considered when developing prevention strategies and treatment plans for MRSA infection in pediatric patients with CF.
Insights
Neighborhood deprivation significantly increases methicillin-resistant Staphylococcus aureus (MRSA) risk in pediatric cystic fibrosis (CF) patients. This factor doubles the odds of MRSA infection, highlighting the need for community-level considerations in prevention strategies.
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.
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