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. 2020 Mar 3;70(6):1021-1028.
doi: 10.1093/cid/ciz323.

Public Health Importance of Invasive Methicillin-sensitive Staphylococcus aureus Infections: Surveillance in 8 US Counties, 2016

Kelly A Jackson  1 , Runa H Gokhale  1 , Joelle Nadle  2 , Susan M Ray  3 , Ghinwa Dumyati  4 , William Schaffner  5 , David C Ham  1 , Shelley S Magill  1 , Ruth Lynfield  6 , Isaac See  1
Affiliations

Public Health Importance of Invasive Methicillin-sensitive Staphylococcus aureus Infections: Surveillance in 8 US Counties, 2016

Kelly A Jackson et al. Clin Infect Dis. .

Abstract

Background: Public health and infection control prevention and surveillance efforts in the United States have primarily focused on methicillin-resistant Staphylococcus aureus (MRSA). We describe the public health importance of methicillin-susceptible S. aureus (MSSA) in selected communities.

Methods: We analyzed Emerging Infections Program surveillance data for invasive S. aureus (SA) infections (isolated from a normally sterile body site) in 8 counties in 5 states during 2016. Cases were considered healthcare-associated if culture was obtained >3 days after hospital admission; if associated with dialysis, hospitalization, surgery, or long-term care facility (LTCF) residence within 1 year prior; or if a central venous catheter was present ≤2 days prior. Incidence per 100 000 census population was calculated, and a multivariate logistic regression model with random intercepts was used to compare MSSA risk factors with those of MRSA.

Results: Invasive MSSA incidence (31.3/100 000) was 1.8 times higher than MRSA (17.5/100 000). Persons with MSSA were more likely than those with MRSA to have no underlying medical conditions (adjusted odds ratio [aOR], 2.06; 95% confidence interval [CI], 1.26-3.39) and less likely to have prior hospitalization (aOR, 0.70; 95% CI, 0.60-0.82) or LTCF residence (aOR, 0.37; 95% CI, 0.29-0.47). MSSA accounted for 59.7% of healthcare-associated cases and 60.1% of deaths.

Conclusions: Although MRSA tended to be more closely associated with healthcare exposures, invasive MSSA is a substantial public health problem in the areas studied. Public health and infection control prevention efforts should consider MSSA prevention in addition to MRSA.

Keywords: MSSA; MSSA burden; methicillin-sensitive Staphylococcus aureus.

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Conflict of interest statement

Potential conflicts of interest. W. S. reports personal fees from Pfizer, Merck, Dynavax, Roche, Seqirus, SutroVax, and Shionogi outside the submitted work. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Invasive MSSA and MRSA incidence per 100 000 population by site, epidemiologic classification, race, and age, 2016. Abbreviations: CA, California; GA, Georgia; MN, Minnesota; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-susceptible Staphylococcus aureus; NY, New York; TN, Tennessee.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Active bacterial core surveillance report, Emerging Infections Program Network, methicillin-resistant Staphylococcus aureus. 2014. Available at: https://www.cdc.gov/abcs/reports-findings/survreports/mrsa14.html. Accessed 14 November 2018.
    1. Klevens RM, Morrison MA, Nadle J, et al. ; Active Bacterial Core Surveillance (ABCs) MRSA Investigators. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007; 298:1763–71. - PubMed
    1. Iwamoto M, Mu Y, Lynfield R, et al. Trends in invasive methicillin-resistant Staphylococcus aureus infections. Pediatrics 2013; 132:e817–24. - PMC - PubMed
    1. Nguyen D, Lessa F, Bellflower R, et al. Invasive methicillin-resistant Staphylococcus aureus infections among patients on chronic dialysis in the United States, 2005–2011. Clin Infect Dis 2013; 57:1393–400. - PMC - PubMed
    1. Dantes R, Mu Y, Aragon D, et al. National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011. JAMA Intern Med 2013;173:1970–8. - PMC - PubMed

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