Abstract
Background:Antibiotic resistant bacteria like community-onset methicillin resistant Staphylococcus aureus (CO-MRSA) have continued to cause infections in children at alarming rates and are associated with health disparities. Geospatial analyses of individual and area level data can enhance disease surveillance and identify socio-demographic and geographic indicators to explain CO-MRSA disease transmission patterns and risks.Methods:A case control epidemiology approach was undertaken to compare children with CO-MRSA to a noninfectious condition (unintentional traumatic brain injury (uTBI)). In order to better understand the impact of place based risks in developing these types of infections, data from electronic health records (EHR) were obtained from CO-MRSA cases and compared to EHR data from controls (uTBI). US Census data was used to determine area level data. Multi-level statistical models were performed using risk factors determined a priori and geospatial analyses were conducted and mapped.Results:From 2002–2010, 4,613 with CO-MRSA and 34,758 with uTBI were seen from two pediatric hospitals in Atlanta, Georgia. Hispanic children had reduced odds of infection; females and public health insurance were more likely to have CO-MRSA. Spatial analyses indicate significant ‘hot spots’ for CO-MRSA and the overall spatial cluster locations, differed between CO-MRSA cases and uTBI controls.Conclusions:Differences exist in race, age, and type of health insurance between CO-MRSA cases compared to noninfectious control group. Geographic clustering of cases is distinct from controls, suggesting placed based factors impact risk for CO-MRSA infection.
Highlights
Ever since John Snow identified the Broad Street public water pump as the source of cholera in London in 1854, the cluster-mapping of infectious diseases has been an important tool for understanding the spread of disease and identifying potential public health interventions
It has been suggested that this disparity in risk for invasive disease may be due to socioeconomic factors [11, 12], but this is not well studied for community-onset methicillin resistant Staphylococcus aureus (CO-MRSA) infections or how it contributes to disease patterns, among children [6, 7, 9]
Study Design A case-control epidemiology study was conducted on patients treated from two major pediatric hospitals located in Atlanta, Georgia from 2002 through 2010
Summary
Ever since John Snow identified the Broad Street public water pump as the source of cholera in London in 1854, the cluster-mapping of infectious diseases has been an important tool for understanding the spread of disease and identifying potential public health interventions. It has been suggested that this disparity in risk for invasive disease may be due to socioeconomic factors [11, 12], but this is not well studied for CO-MRSA infections or how it contributes to disease patterns, among children [6, 7, 9]. Antibiotic resistant bacteria like community-onset methicillin resistant Staphylococcus aureus (CO-MRSA) have continued to cause infections in children at alarming rates and are associated with health disparities. In order to better understand the impact of place based risks in developing these types of infections, data from electronic health records (EHR) were obtained from CO-MRSA cases and compared to EHR data from controls (uTBI). Geographic clustering of cases is distinct from controls, suggesting placed based factors impact risk for CO-MRSA infection
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