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High Burden of Staphylococcus aureus Among Native American Individuals on the White Mountain Apache Tribal Lands
Catherine G Sutcliffe1, Lindsay R Grant1, Angelina Reid1
1Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Background:
This study was done to determine the burden of invasive Staphylococcus aureus on the White Mountain Apache Tribal lands.
Methods:
Active population and laboratory-based surveillance for invasive S aureus infections was conducted from May 2016 to April 2018. A case was defined as a Native American individual living on or around the White Mountain Apache Tribal lands with S aureus isolated from a normally sterile body site.
Results:
Fifty-three cases were identified. Most cases were adults (90.6%) and had ≥1 underlying medical condition (86.8%), the most common of which were diabetes (49.1%) and obesity (41.5%). A total of 26.4% cases were categorized as community acquired. Most infections were methicillin-resistant (75.5%). A total of 7.5% of cases required amputation, and 7.7% of cases died within 30 days of initial culture. The incidence of invasive S aureus was 156.3 per 100 000 persons. The age-adjusted incidence of invasive methicillin-resistant S aureus was 138.2 per 100 000 persons.
Conclusions:
This community has a disproportionately high burden of invasive methicillin-resistant S aureus compared with the general US population. Interventions are urgently needed to reduce the morbidity and mortality associated with these infections.
Insights
Invasive Staphylococcus aureus infections, particularly methicillin-resistant strains, disproportionately affect the White Mountain Apache community. Urgent interventions are needed to address this high burden of disease and reduce severe outcomes.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Invasive Staphylococcus aureus infections pose a significant health concern.
- Understanding the burden of these infections in specific populations is crucial for targeted interventions.
Purpose of the Study:
- To determine the burden of invasive Staphylococcus aureus infections on White Mountain Apache Tribal lands.
- To assess the characteristics and incidence of these infections within this community.
Main Methods:
- Active, population- and laboratory-based surveillance was conducted from May 2016 to April 2018.
- Cases included Native American individuals residing on or near the White Mountain Apache Tribal lands with S aureus isolated from normally sterile sites.
Main Results:
- Fifty-three cases of invasive S aureus were identified, predominantly in adults (90.6%) with underlying conditions like diabetes and obesity.
- Most infections were methicillin-resistant (75.5%), with a significant incidence of 156.3 per 100,000 persons.
- Community-acquired infections accounted for 26.4%, and severe outcomes included amputation (7.5%) and 30-day mortality (7.7%).
Conclusions:
- The White Mountain Apache community experiences a disproportionately high burden of invasive methicillin-resistant Staphylococcus aureus compared to the general US population.
- High rates of underlying medical conditions contribute to the susceptibility and severity of these infections.
- Urgent public health interventions are necessary to mitigate the morbidity and mortality associated with invasive S aureus infections in this population.
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