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S. aureus Infections in Chicago, 2006-2014: Increase in CA MSSA and Decrease in MRSA Incidence

Published online by Cambridge University Press:  14 September 2017

M. Ellen Acree ,
Ethan Morgan  and
Michael Z. David
M. Ellen Acree*
Affiliation:
Department of Medicine, Public Health Sciences, University of Chicago, Chicago, Illinois Department of Pediatrics, Public Health Sciences, University of Chicago, Chicago, Illinois
Ethan Morgan
Affiliation:
Department of Public Health Sciences, University of Chicago, Chicago, Illinois
Michael Z. David
Affiliation:
Department of Medicine, Public Health Sciences, University of Chicago, Chicago, Illinois Department of Pediatrics, Public Health Sciences, University of Chicago, Chicago, Illinois Department of Public Health Sciences, University of Chicago, Chicago, Illinois
*
Address correspondence to M. Ellen Acree, MD, 2122 Dewey Ave, Evanston, IL 60201 (ellenacree@gmail.com).
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Abstract

OBJECTIVE

To examine trends in Staphylococcus aureus infections in adults and children at a single academic center in 2006–2014.

DESIGN

Retrospective cohort study.

SETTING

Inpatient, outpatient, and emergency department settings in a private, tertiary referral center.

PATIENTS

Patients with an infection culture that grew S. aureus in January 1, 2006, through March 31, 2014.

METHODS

The first isolate per year for each patient was classified as community-associated (CA-), healthcare-associated (HA-), or HA-community–onset S. aureus. The incidence density of S. aureus, methicillin-susceptible S. aureus (MSSA), and methicillin-resistant S. aureus (MRSA) infections were calculated per quarter year.

RESULTS

Overall, 5,491 MRSA and 5,398 MSSA isolates were included. MRSA infections decreased by an average of 5.2% annually (P<.001). MRSA skin and soft-tissue infection (SSTI) incidence density decreased in adults (−3.5%; P<.001) and children (−2.9%; P=.004). MSSA infections at all anatomic sites increased by an average of 1.9% annually (P=.007) in adults and decreased 5.1% annually (P<.001) in children. MSSA SSTI incidence density increased in adults (+3.8%; P<.001) and children (+5.6%; P<.001). For MRSA and MSSA SSTI isolates, susceptibility to tetracycline and clindamycin decreased significantly.

CONCLUSIONS

In 2006–2014, MRSA SSTI incidence decreased among children and adults. MSSA SSTI incidence density increased in children and adults, suggesting that current empiric SSTI treatment recommendations may not be optimal. Adults experienced an overall increase in MSSA infections, which may prompt consideration of the need for horizontal infection control practices to decrease MSSA infection risk.

Infect Control Hosp Epidemiol 2017;38:1226–1234

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 10 , October 2017 , pp. 1226 - 1234
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION: The results of this study were presented in a poster presentation at IDWeek 2016 in New Orleans, Louisiana, on October 9, 2016, poster number 1116.

References

REFERENCES

1. Lowy, FD. Staphylococcus aureus infections. N Engl J Med 1998;339:520–532.CrossRefGoogle ScholarPubMed
2. David, MZ, Daum, RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev 2010;23:616–687.Google Scholar
3. Klein, E, Smith, DL, Laxminarayan, R. Community-associated methicillin-resistant Staphylococcus aureus in outpatients, United States, 1999-2006. Emerg Infect Dis 2009;15:1925–1930.Google ScholarPubMed
4. Como-Sabetti, K, Harriman, KH, Buck, JM, Glennen, A, Boxrud, DJ, Lynfield, R. Community-associated methicillin-resistant Staphylococcus aureus: trends in case and isolate characteristics from six years of prospective surveillance. Public Health Rep 2009;124:427–435.Google Scholar
5. McCaig, LF, McDonald, LC, Mandal, S, Jernigan, DB. Staphylococcus aureus-associated skin and soft tissue infections in ambulatory care. Emerg Infect Dis 2006;12:1715–1723.CrossRefGoogle ScholarPubMed
6. Landrum, ML, Neumann, C, Cook, C, et al. Epidemiology of Staphylococcus aureus blood and skin and soft tissue infections in the US military health system, 2005–2010. JAMA 2012;308:50–59.CrossRefGoogle ScholarPubMed
7. Dukic, VM, Lauderdale, DS, Wilder, J, Daum, RS, David, MZ. Epidemics of community-associated methicillin-resistant Staphylococcus aureus in the United States: a meta-analysis. PLoS One 2013;8:e52722.Google Scholar
8. David, MZ, Cadilla, A, Boyle-Vavra, S, Daum, RS. Replacement of HA-MRSA by CA-MRSA infections at an academic medical center in the midwestern United States, 2004-5 to 2008. PLoS One 2014;9:e92760.Google Scholar
9. Schramm, GE, Johnson, JA, Doherty, JA, Micek, ST, Kollef, MH. Increasing incidence of sterile-site infections due to non-multidrug-resistant, oxacillin-resistant Staphylococcus aureus among hospitalized patients. Infect Control Hosp Epidemiol 2007;28:95–97.Google Scholar
10. Kaplan, SL, Hulten, KG, Gonzalez, BE, et al. Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clin Infect Dis 2005;40:1785–1791.Google Scholar
11. Klein, E, Smith, DL, Laxminarayan, R. Hospitalizations and deaths caused by methicillin-resistant Staphylococcus aureus, United States, 1999–2005. Emerg Infect Dis 2007;13:1840–1846.Google Scholar
12. Kennedy, LA, Gill, JA, Schultz, ME, Irmler, M, Gordin, FM. Inside-out: the changing epidemiology of methicillin-resistant Staphylococcus aureus . Infect Control Hosp Epidemiol 2010;31:983–985.CrossRefGoogle ScholarPubMed
13. Seal, JB, Moreira, B, Bethel, CD, Daum, RS. Antimicrobial resistance in Staphylococcus aureus at the University of Chicago Hospitals: a 15-year longitudinal assessment in a large university-based hospital. Infect Control Hosp Epidemiol 2003;24:403–408.Google Scholar
14. David, MZ, Crawford, SE, Boyle-Vavra, SB, Hostetler, MA, Kim, DC, Daum, RS. Contrasting pediatric and adult methicillin-resistant Staphylococcus aureus isolates. Emerg Infect Dis 2006;12:631–637.Google Scholar
15. David, MZ, Glikman, D, Crawford, SE, et al. What is community-associated methicillin-resistant Staphylococcus aureus? J Infect Dis 2008;197:1235–1243.Google Scholar
16. David, MZ, Boyle-Vavra, S, Zychowski, DL, Daum, RS. Methicillin-susceptible Staphylococcus aureus as a predominantly healthcare-associated pathogen: a possible reversal of roles? PLoS One 2011;6:e18217.Google Scholar
17. Popovich, KJ, Weinstein, RA, Hota, B. Are community-associated methicillin-resistant Staphylococcus aureus (MRSA) strains replacing traditional nosocomial MRSA strains? Clin Infect Dis 2008;46:787–794.Google Scholar
18. Tracy, LA, Furuno, JP, Harris, AD, Singer, M, Langenberg, P, Roghmann, MC. Staphylococcus aureus infections in US veterans, Maryland, USA, 1999–2008. Emerg Infect Dis 2011;17:441–448.Google Scholar
19. Casey, JA, Cosgrove, SE, Stewart, WF, Pollak, J, Schwartz, BS. A population-based study of the epidemiology and clinical features of methicillin-resistant Staphylococcus aureus infection in Pennsylvania, 2001–2010. Epidemiol Infect 2013;141:1166–1179.Google Scholar
20. McMullen, KM, Warren, DK, Woeltje, KF. The changing susceptibilities of methicillin-resistant Staphylococcus aureus at a midwestern hospital: the emergence of “community-associated” MRSA. Am J Infect Control 2009;37:454–457.Google Scholar
21. Braun, L, Craft, D, Williams, R, Tuamokumo, F, Ottolini, M. Increasing clindamycin resistance among methicillin-resistant Staphylococcus aureus in 57 northeast United States military treatment facilities. Pediatr Infect Dis J 2005;24:622–626.Google Scholar
22. Frei, CR, Makos, BR, Daniels, KR, Oramasionwu, CU. Emergence of community-acquired methicillin-resistant Staphylococcus aureus skin and soft tissue infections as a common cause of hospitalization in United States children. J Pediatr Surg 2010;45:1967–1974.Google Scholar
23. Delorme, T, Rose, S, Senita, J, Callahan, C, Nasr, P. Epidemiology and susceptibilities of methicillin-resistant Staphylococcus aureus in northeastern Ohio. Am J Clin Pathol 2009;132:668–677.Google Scholar
24. Purcell, K, Fergie, J. Epidemic of community-acquired methicillin-resistant Staphylococcus aureus infections: a 14-year study at Driscoll Children’s Hospital. Arch Pediatr Adolesc Med 2005;159:980–985.Google Scholar
25. Stevenson, KB, Searle, K, Stoddard, GJ, Samore, M. Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci in rural communities, western United States. Emerg Infect Dis 2005;11:895–903.CrossRefGoogle ScholarPubMed
26. Edelsberg, J, Taneja, C, Zervos, M, et al. Trends in US hospital admissions for skin and soft tissue infections. Emerg Infect Dis 2009;15:1516–1518.CrossRefGoogle ScholarPubMed
27. Pallin, DJ, Egan, DJ, Pelletier, AJ, Espinola, JA, Hooper, DC, Camargo, CA Jr. Increased US emergency department visits for skin and soft tissue infections, and changes in antibiotic choices, during the emergence of community-associated methicillin-resistant Staphylococcus aureus . Ann Emerg Med 2008;51:291–298.CrossRefGoogle ScholarPubMed
28. Gerber, JS, Coffin, SE, Smathers, SA, Zaoutis, TE. Trends in the incidence of methicillin-resistant Staphylococcus aureus infection in children’s hospitals in the United States. Clin Infect Dis 2009;49:65–71.Google Scholar
29. Gupta, K, Macintyre, A, Vanasse, G, Dembry, LM. Trends in prescribing beta-lactam antibiotics for treatment of community-associated methicillin-resistant Staphylococcus aureus infections. J Clin Microbiol 2007;45:3930–3934.Google Scholar
30. Sutter, DE, Milburn, E, Chukwuma, U, Dzialowy, N, Maranich, AM, Hospenthal, DR. Changing susceptibility of Staphylococcus aureus in a US pediatric population. Pediatrics 2016;137:e20153099.CrossRefGoogle Scholar
31. Kallen, AJ, Mu, Y, Bulens, S, et al. Health care-associated invasive MRSA infections, 2005-2008. JAMA 2010;304:641–648.Google Scholar
32. Burton, DC, Edwards, JR, Horan, TC, Jernigan, JA, Fridkin, SK. Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 1997-2007. JAMA 2009;301:727–736.Google Scholar
33. Price, JR, Cole, K, Bexley, A, et al. Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing. Lancet Infect Dis 2017;17:207–214.Google Scholar