Over-representation of Samoan/Pacific Islanders among patients with methicillin-resistant Staphylococcus aureus (MRSA) infections at a large family practice clinic in Anchorage, Alaska, 1996-2000.
Two pediatricians in Anchorage observed that among patients of Samoan/Pacific Islander (S/PI) descent, bacterial wound cultures that grew Staphylococcus aureus often yielded methicillin-resistant isolates. The Alaska Section of Epidemiology performed chart reviews of patients that visited a large family practice clinic in Anchorage, Alaska, from 1996 through April 2000, and who were diagnosed with a skin infection. Eight of 204 patients were identified with culture-confirmed MRSA infections. Eighty percent (4 of 5) of S/PI patients had resistant isolates compared with 12% (4 of 34) of non S/PI patients (Yates corrected chi2 = 8.61, p-value = 0.003). Although subject to limitations, these data support similar findings documented by other studies that suggest MRSA infections disproportionately affect persons of S/PI origin. This study also suggests that it would be prudent to reduce the threshold of clinical suspicion for obtaining a skin culture among S/PI patients in Alaska, and avoid beta-lactam antibiotics until culture results are received.
Section of Epidemiology, Alaska Department of Health and Social Services, P. O. Box 240249, Anchorage, AK 99524-0249, USA. louisa_castrodale@health.state.ak.us
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Castrodale
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Beller
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Gessner
D000413:Alaska / Q000453:epidemiology; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D016106:Methicillin Resistance / Q000208:ethnology*; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D018947:Samoa / Q000208:ethnology; D013207:Staphylococcal Skin Infections / Q000188:drug therapy* / Q000208:ethnology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification