title: Spatial analysis of community-onset Staphylococcus aureus bacteremia in Queensland, Australia.
abstract: OBJECTIVE
  To investigate and describe the relationship between indigenous Australian populations, residential aged care services, and community-onset Staphylococcus aureus bacteremia (SAB) among patients admitted to public hospitals in Queensland, Australia.
  
  
  METHODS
  Ecological study.
  
  
  METHODS
  We used administrative healthcare data linked to microbiology results from patients with SAB admitted to Queensland public hospitals from 2005 through 2010 to identify community-onset infections. Data about indigenous Australian population and residential aged care services at the local government area level were obtained from the Queensland Office of Economic and Statistical Research. Associations between community-onset SAB and indigenous Australian population and residential aged care services were calculated using Poisson regression models in a Bayesian framework. Choropleth maps were used to describe the spatial patterns of SAB risk.
  
  
  RESULTS
  We observed a 21% increase in relative risk (RR) of bacteremia with methicillin-susceptible S. aureus (MSSA; RR, 1.21 [95% credible interval, 1.15-1.26]) and a 24% increase in RR with nonmultiresistant methicillin-resistant S. aureus (nmMRSA; RR, 1.24 [95% credible interval, 1.13-1.34]) with a 10% increase in the indigenous Australian population proportion. There was no significant association between RR of SAB and the number of residential aged care services. Areas with the highest RR for nmMRSA and MSSA bacteremia were identified in the northern and western regions of Queensland.
  
  
  CONCLUSIONS
  The RR of community-onset SAB varied spatially across Queensland. There was increased RR of community-onset SAB with nmMRSA and MSSA in areas of Queensland with increased indigenous population proportions. Additional research should be undertaken to understand other factors that increase the risk of infection due to this organism.
authors: Centre for Healthcare Related Infection Surveillance and Prevention, Herston, Brisbane, Queensland, Australia.
authors: John
authors: J
authors: Marquess
authors: Wenbiao
authors: W
authors: Hu
authors: Graeme R
authors: GR
authors: Nimmo
authors: Archie C A
authors: AC
authors: Clements
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D001499:Bayes Theorem; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D062305:Geographic Mapping; D006707:Homes for the Aged; D006779:Hospitals, Public; D006801:Humans; D015994:Incidence; D055624:Methicillin-Resistant Staphylococcus aureus; D016012:Poisson Distribution; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology