Details:

Alternative Title:
Clin Infect Dis
Personal Author:
See, Isaac ; Wesson, Paul ; Gualandi, Nicole ; Dumyati, Ghinwa ; Harrison, Lee H. ; ... More +
See, Isaac ; Wesson, Paul ; Gualandi, Nicole ; Dumyati, Ghinwa ; Harrison, Lee H. ; Lesher, Lindsey ; Nadle, Joelle ; Petit, Susan ; Reisenauer, Claire ; Schaffner, William ; Tunali, Amy ; Mu, Yi ; Ahern, Jennifer ; Less -
Description:
Introduction Invasive community-associated methicillin-resistant Staphylococcus aureus (MRSA) incidence in the United States is higher among black persons than white persons. We explored the extent to which socioeconomic factors might explain this racial disparity. Methods A retrospective cohort was based on CDC’s Emerging Infections Program surveillance data for invasive community-associated MRSA cases (isolated from a normally sterile site of an outpatient or on hospital admission day ≤3 in a patient without specified major healthcare exposures) from 2009–2011 in 33 counties of 9 states. We used generalized estimating equations to determine census tract-level factors associated with differences in MRSA incidence and inverse odds ratio weighted mediation analysis to determine the proportion of racial disparity mediated by socioeconomic factors. Results Annual invasive community-associated MRSA incidence was 4.59/100,000 among whites and 7.60/100,000 among blacks (rate ratio: 1.66, 95% CI, 1.52–1.80). In the mediation analysis, after accounting for census tract-level measures of federally-designated medically underserved areas, education, income, housing value, and rural status, 91% of the original racial disparity was explained; no significant association of black race with community-associated MRSA remained (rate ratio: 1.05, 95% CI, 0.92–1.20). Conclusions The racial disparity in invasive community-associated MRSA rates was almost entirely mediated by socioeconomic factors. The specific factors that underlie the association between tract-level socioeconomic measures and MRSA incidence, which may include modifiable social (e.g., poverty, crowding) and biological factors (not explored in this analysis), should be elucidated to define strategies for reducing racial disparities in community-associated MRSA rates.
Subject:
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Adult
Aged
Community-Acquired Infections
Comorbidity
Ethnicity
Female
Healthcare Disparities
Humans
Incidence
Male
Methicillin-Resistant Staphylococcus Aureus
Middle Aged
Socioeconomic Factors
Staphylococcal Infections

Source:
Clin Infect Dis. 64(5):597-604 ;
Pubmed ID:
28362911
Pubmed Central ID:
PMC5656382
Document Type:
Journal Article ;
Funding:
CC999999/Intramural CDC HHS/United States ; T32 MH019105/MH/NIMH NIH HHS/United States ;
CC999999/Intramural CDC HHS/United States ; T32 MH019105/MH/NIMH NIH HHS/United States ; Less -
Place as Subject:
United States ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:652b195ad2abed0253482993df8319fc44931b1491c5d8bd38f081597e3e859d
File Type:

Supporting Files

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