title: Incidence and risk factors for community-associated methicillin-resistant Staphylococcus aureus in New York City, 2006-2012.
abstract: This study aims to describe changes in incidence and risk factors for community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) infections upon admission to two New York City hospitals from 2006 to 2012. We examined the first hospitalization for adult patients using electronic health record and administrative data and determined the annual incidence/1000 admissions of total S. aureus, total MRSA, and CA-MRSA (within 48 h of admission) in clinical specimens over the study period. Logistic regression was used to identify factors associated with CA-MRSA in 2006 and 2012. In 137 350 admissions, the incidence of S. aureus, MRSA, and CA-MRSA/1000 admissions were 15·6, 7·0, and 3·5, respectively. The total S. aureus and MRSA isolations decreased significantly over the study period (27% and 25%, respectively) while CA-MRSA incidence was unchanged. CA-MRSA increased as a proportion of all MRSA between 2006 (46%) and 2012 (62%), and was most frequently isolated from respiratory (1·5/1000) and blood (0·7/1000) cultures. Logistic regression analysis of factors associated with isolation of CA-MRSA showed that age ⩾65 years [odds ratio (OR) 2·3, 95% confidence interval (CI) 1·2-4·5], male gender (OR 1·8, 95% CI 1·2-2·8) and history of renal failure (OR 2·6, 95% CI 1·6-4·2) were significant predictors of infection in 2006. No predictors were identified in 2012.
authors.affiliation: Department of Epidemiology,Mailman School of Public Health,Columbia University,New York,NY,USA.
authors.forename: P
authors.initials: P
authors.lastname: Baker
authors.affiliation: Department of Epidemiology,Mailman School of Public Health,Columbia University,New York,NY,USA.
authors.forename: B
authors.initials: B
authors.lastname: Cohen
authors.affiliation: Columbia University School of Nursing,New York,NY,USA.
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Epidemiology,Mailman School of Public Health,Columbia University,New York,NY,USA.
authors.forename: E
authors.initials: E
authors.lastname: Larson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008712:Methicillin / Q000494:pharmacology*; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D012621:Seasons; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin
keywords: Methicillin-resistant S. aureus (MRSA)