Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York Community Health Centers

N Piper Jenks¹, M Pardos de la Gandara², B M D'Orazio³, J Correa da Rosa⁴, R G Kost⁵, C Khalida⁶, K S Vasquez⁷, C Coffran⁸, M Pastagia⁹, T H Evering¹⁰, C Parola¹¹, T Urban¹², S Salvato¹³, F Barsanti¹⁴, B S Coller¹⁵, J N Tobin¹⁶

Affiliations

¹ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA; Hudson River HealthCare, 1037 Main Street, Peekskill, NY 10566, USA. Electronic address: njenks@HRHCARE.ORG.
² Laboratory of Microbiology & Infectious Diseases, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: mpardos@rockefeller.edu.
³ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA. Electronic address: bdorazio@CDNetwork.org.
⁴ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: jcorreadar@mail.rockefeller.edu.
⁵ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: kostr@rockefeller.edu.
⁶ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA. Electronic address: ckhalida@CDNetwork.org.
⁷ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: kvasquez@rockefeller.edu.
⁸ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: cameron@rockefeller.edu.
⁹ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: minapastagia@yahoo.com.
¹⁰ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: tevering@adarc.org.
¹¹ Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Claude.Parola@urbanhealthplan.org.
¹² Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Tracie.Urban@urbanhealthplan.org.
¹³ Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Salvatsc@gmail.com.
¹⁴ Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Franco.Barsanti@urbanhealthplan.org.
¹⁵ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: collerb@rockefeller.edu.
¹⁶ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA; Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: JNTobin@CDNetwork.org.

PMID: 27773780
PMCID: PMC5154877
DOI: 10.1016/j.tmaid.2016.10.003

Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York Community Health Centers

N Piper Jenks et al. Travel Med Infect Dis. 2016 Nov-Dec.

. 2016 Nov-Dec;14(6):551-560.

doi: 10.1016/j.tmaid.2016.10.003. Epub 2016 Oct 20.

Authors

Affiliations

¹ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA; Hudson River HealthCare, 1037 Main Street, Peekskill, NY 10566, USA. Electronic address: njenks@HRHCARE.ORG.
² Laboratory of Microbiology & Infectious Diseases, The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: mpardos@rockefeller.edu.
³ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA. Electronic address: bdorazio@CDNetwork.org.
⁴ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: jcorreadar@mail.rockefeller.edu.
⁵ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: kostr@rockefeller.edu.
⁶ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA. Electronic address: ckhalida@CDNetwork.org.
⁷ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: kvasquez@rockefeller.edu.
⁸ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: cameron@rockefeller.edu.
⁹ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: minapastagia@yahoo.com.
¹⁰ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: tevering@adarc.org.
¹¹ Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Claude.Parola@urbanhealthplan.org.
¹² Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Tracie.Urban@urbanhealthplan.org.
¹³ Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Salvatsc@gmail.com.
¹⁴ Urban Health Plan, Inc., 1065 Southern Boulevard, Bronx, NY 10459, USA. Electronic address: Franco.Barsanti@urbanhealthplan.org.
¹⁵ Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: collerb@rockefeller.edu.
¹⁶ Clinical Directors Network, Inc (CDN), 5 West 37th Street, 10th Floor, New York, NY 10018, USA; Center for Clinical and Translational Science (CCTS), The Rockefeller University, 1230 York Avenue, New York, NY 10065, USA. Electronic address: JNTobin@CDNetwork.org.

PMID: 27773780
PMCID: PMC5154877
DOI: 10.1016/j.tmaid.2016.10.003

Abstract

Background: Staphylococcus aureus is the most common cause of Skin and Soft Tissue Infections (SSTIs) in the community in the United States of America. Community Health Centers (CHC) serve as primary care providers for thousands of immigrants in New York.

Methods: As part of a research collaborative, 6 New York City-area CHCs recruited patients with SSTIs. Characterization was performed in all S. aureus isolates from wounds and nasal swabs collected from patients. Statistical analysis examined the differences in wound and nasal cultures among immigrant compared to native-born patients.

Results: Wound and nasal specimens were recovered from 129 patients and tested for antibiotic susceptibility. 40 patients were immigrants from 15 different countries. Although not statistically significant, immigrants had lower rates of MRSA infections (n = 15) than did native-born participants, and immigrants showed significantly higher rates of MSSA wound cultures (n = 11) (OR = 3.5, 95% CI: 1.3, 9.7).

Conclusions: In our study, immigrants were more likely to present with SSTIs caused by MSSA than US-born patients. Immigants also reported lower frequencies of antibiotic prescription or consumption in the months prior to SSTI infection. This suggests that antibiotic resistance may vary regionally and that immigrants presenting with SSTIs may benefit from a broader range of antibiotics.

Keywords: Antibiotic resistance; Foreign born; Practice-based Research Network (PBRN); Skin and soft tissue infection (SSTI); Staphylococcus aureus.

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Conflict of interest statement

CONFLICTING AND COMPETING INTERESTS The authors do not have financial or other relationships with the manufacturer(s) of any commercial product(s) or provider(s) of any commercial service(s) discussed in this case report.

Figures

**Figure 1. Examples of Lesions from Digital Library**
Both lesions pictured above were located on the axilla.

**Figure 2. Country of Origin for Non-USA Born Participants (n=40)**
Dots mark the geographic location of the countries of origin of foreign-born patients in the study: Different colors mark different countries and both the size of dots and the number inside the dots correlate with the number of patients from each country. Mexico, Central and South America, and the Caribbean were categorized as Latin America.

See this image and copyright information in PMC

Comment in

When less is best - Why non U.S. born patients could have less MRSA.
Hagmann SHF. Hagmann SHF. Travel Med Infect Dis. 2016 Nov-Dec;14(6):546-547. doi: 10.1016/j.tmaid.2016.11.013. Epub 2016 Nov 24. Travel Med Infect Dis. 2016. PMID: 27890666 No abstract available.

References

1. Niska R, Bhuiya F, Xu J. National Hospital Ambulatory Medical Care Survey: 2007 emergency department summary. 2010:1–31. - PubMed
1. Uhlemann A-C, Otto M, Lowy FD, DeLeo FR. Evolution of community- and healthcare-associated methicillin-resistant Staphylococcus aureus. Infection, Genetics and Evolution. 2014;21:563–574. - PMC - PubMed
1. Miko BA, Uhlemann A-C, Gelman A, Lee CJ, Hafer CA, Sullivan SB, et al. High prevalence of colonization with Staphylococcus aureus clone USA300 at multiple body sites among sexually transmitted disease clinic patients: an unrecognized reservoir. Microbes and Infection. 2012;14:1040–1043. - PMC - PubMed
1. Grundmann H, Schouls LM, Aanensen DM, Pluister GN, Tami A, Chlebowicz M, et al. The dynamic changes of dominant clones of Staphylococcus aureus causing bloodstream infections in the European region: results of a second structured survey. Euro Surveill. 2014;19:1–10. - PubMed
1. DeLeo FR, Otto M, Kreiswirth BN, Chambers HF. Community-associated meticillin-resistant Staphylococcus aureus. The Lancet. 2010;375:1557–1568. - PMC - PubMed

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Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York Community Health Centers

Affiliations

Differences in prevalence of community-associated MRSA and MSSA among U.S. and non-U.S. born populations in six New York Community Health Centers

Authors

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Abstract

Conflict of interest statement

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