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Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci in rural communities, western United States.

Stevenson KB, Searle K, Stoddard GJ, Samore M - Emerging Infect. Dis. (2005)

Bottom Line: Among the 724 MRSA cases available for evaluation, 405 (56%) were healthcare-associated (HA-MRSA), and 319 (44%) were community-associated (CA-MRSA).Based on epidemiologic criteria, a large proportion of MRSA cases were community-associated.CA-MRSA rates were predictive of institutional MRSA rates.

View Article: PubMed Central - PubMed

Affiliation: Qualis Health, Boise, Idaho 83712-7756, USA. kurts@qualishealth.org

ABSTRACT
The impact and prevalence of antimicrobial drug resistance in rural community healthcare settings is uncertain. Prospective surveillance in 51 rural hospitals in Idaho and Utah examined the epidemiologic features of clinical cases of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Thirty-two cases of VRE were reported; for 6, the patient had no prior healthcare exposure or coexisting condition. Among the 724 MRSA cases available for evaluation, 405 (56%) were healthcare-associated (HA-MRSA), and 319 (44%) were community-associated (CA-MRSA). The characteristics of HA-MRSA and CA-MRSA patients with coexisting factors were similar, which suggests community transmission of healthcare strains. CA-MRSA cases without coexisting factors, however, demonstrated features previously reported for community strains. MRSA infections were substantially more frequent than VRE in rural communities in the western United States. Based on epidemiologic criteria, a large proportion of MRSA cases were community-associated. CA-MRSA rates were predictive of institutional MRSA rates.

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Related in: MedlinePlus

Box plot of incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcal (VRE) infections. CA, community-associated; HA, healthcare-associated.
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Figure 1: Box plot of incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcal (VRE) infections. CA, community-associated; HA, healthcare-associated.

Mentions: Incidence rates of VRE and MRSA infections, particularly of HA-MRSA, varied substantially across institutions (Figure). Rates of CA-MRSA correlated strongly with HA-MRSA rates, regardless of whether CA-MRSA rates were denominated by community or county population size (Table 5). The rate of HA-MRSA in hospitals belonging to the third quintile of CA-MRSA rates was 11-fold higher than in hospitals with no CA-MRSA (first and second quintiles). The rate of HA-MRSA in hospitals belonging to the fourth and fifth quintiles of CA-MRSA rates was >30-fold higher than in hospitals with no CA-MRSA. This association was independent of hospital bed size.


Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci in rural communities, western United States.

Stevenson KB, Searle K, Stoddard GJ, Samore M - Emerging Infect. Dis. (2005)

Box plot of incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcal (VRE) infections. CA, community-associated; HA, healthcare-associated.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3367578&req=5

Figure 1: Box plot of incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcal (VRE) infections. CA, community-associated; HA, healthcare-associated.
Mentions: Incidence rates of VRE and MRSA infections, particularly of HA-MRSA, varied substantially across institutions (Figure). Rates of CA-MRSA correlated strongly with HA-MRSA rates, regardless of whether CA-MRSA rates were denominated by community or county population size (Table 5). The rate of HA-MRSA in hospitals belonging to the third quintile of CA-MRSA rates was 11-fold higher than in hospitals with no CA-MRSA (first and second quintiles). The rate of HA-MRSA in hospitals belonging to the fourth and fifth quintiles of CA-MRSA rates was >30-fold higher than in hospitals with no CA-MRSA. This association was independent of hospital bed size.

Bottom Line: Among the 724 MRSA cases available for evaluation, 405 (56%) were healthcare-associated (HA-MRSA), and 319 (44%) were community-associated (CA-MRSA).Based on epidemiologic criteria, a large proportion of MRSA cases were community-associated.CA-MRSA rates were predictive of institutional MRSA rates.

View Article: PubMed Central - PubMed

Affiliation: Qualis Health, Boise, Idaho 83712-7756, USA. kurts@qualishealth.org

ABSTRACT
The impact and prevalence of antimicrobial drug resistance in rural community healthcare settings is uncertain. Prospective surveillance in 51 rural hospitals in Idaho and Utah examined the epidemiologic features of clinical cases of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). Thirty-two cases of VRE were reported; for 6, the patient had no prior healthcare exposure or coexisting condition. Among the 724 MRSA cases available for evaluation, 405 (56%) were healthcare-associated (HA-MRSA), and 319 (44%) were community-associated (CA-MRSA). The characteristics of HA-MRSA and CA-MRSA patients with coexisting factors were similar, which suggests community transmission of healthcare strains. CA-MRSA cases without coexisting factors, however, demonstrated features previously reported for community strains. MRSA infections were substantially more frequent than VRE in rural communities in the western United States. Based on epidemiologic criteria, a large proportion of MRSA cases were community-associated. CA-MRSA rates were predictive of institutional MRSA rates.

Show MeSH
Related in: MedlinePlus