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S. aureus Infections in Chicago, 2006-2014: Increase in CA MSSA and Decrease in MRSA Incidence

Published online by Cambridge University Press:  14 September 2017

M. Ellen Acree ,
Ethan Morgan  and
Michael Z. David
M. Ellen Acree*
Affiliation:
Department of Medicine, Public Health Sciences, University of Chicago, Chicago, Illinois Department of Pediatrics, Public Health Sciences, University of Chicago, Chicago, Illinois
Ethan Morgan
Affiliation:
Department of Public Health Sciences, University of Chicago, Chicago, Illinois
Michael Z. David
Affiliation:
Department of Medicine, Public Health Sciences, University of Chicago, Chicago, Illinois Department of Pediatrics, Public Health Sciences, University of Chicago, Chicago, Illinois Department of Public Health Sciences, University of Chicago, Chicago, Illinois
*
Address correspondence to M. Ellen Acree, MD, 2122 Dewey Ave, Evanston, IL 60201 (ellenacree@gmail.com).
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Abstract

OBJECTIVE

To examine trends in Staphylococcus aureus infections in adults and children at a single academic center in 2006–2014.

DESIGN

Retrospective cohort study.

SETTING

Inpatient, outpatient, and emergency department settings in a private, tertiary referral center.

PATIENTS

Patients with an infection culture that grew S. aureus in January 1, 2006, through March 31, 2014.

METHODS

The first isolate per year for each patient was classified as community-associated (CA-), healthcare-associated (HA-), or HA-community–onset S. aureus. The incidence density of S. aureus, methicillin-susceptible S. aureus (MSSA), and methicillin-resistant S. aureus (MRSA) infections were calculated per quarter year.

RESULTS

Overall, 5,491 MRSA and 5,398 MSSA isolates were included. MRSA infections decreased by an average of 5.2% annually (P<.001). MRSA skin and soft-tissue infection (SSTI) incidence density decreased in adults (−3.5%; P<.001) and children (−2.9%; P=.004). MSSA infections at all anatomic sites increased by an average of 1.9% annually (P=.007) in adults and decreased 5.1% annually (P<.001) in children. MSSA SSTI incidence density increased in adults (+3.8%; P<.001) and children (+5.6%; P<.001). For MRSA and MSSA SSTI isolates, susceptibility to tetracycline and clindamycin decreased significantly.

CONCLUSIONS

In 2006–2014, MRSA SSTI incidence decreased among children and adults. MSSA SSTI incidence density increased in children and adults, suggesting that current empiric SSTI treatment recommendations may not be optimal. Adults experienced an overall increase in MSSA infections, which may prompt consideration of the need for horizontal infection control practices to decrease MSSA infection risk.

Infect Control Hosp Epidemiol 2017;38:1226–1234

Information

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 10 , October 2017 , pp. 1226 - 1234
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION: The results of this study were presented in a poster presentation at IDWeek 2016 in New Orleans, Louisiana, on October 9, 2016, poster number 1116.

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