Abstract
BackgroundThe first Canadian outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified in 2004 in Calgary, Alberta. Using a novel model of MRSA population-based surveillance, sociodemographic risk associations, yearly geospatial dissemination and prevalence of CA-MRSA infections over an 11 year period was identified in an urban healthcare jurisdiction of Calgary.MethodsPositive MRSA case records, patient demographics and laboratory data were obtained from a centralized Laboratory Information System of Calgary Laboratory Services in Calgary, Alberta, Canada between 2004 and 2014. Public census data was obtained from Statistics Canada, which was used to match with laboratory data and mapped using Geographic Information Systems.ResultsDuring the study period, 52.5% of positive MRSA infections in Calgary were CA-MRSA cases. The majority were CMRSA10 (USA300) clones (94.1%; n = 4255), while the remaining case (n = 266) were CMRSA7 (USA400) clones. Period prevalence of CMRSA10 increased from 3.6 cases/100000 population in 2004, to 41.3 cases/100000 population in 2014. Geospatial analysis demonstrated wide dissemination of CMRSA10 annually in the city. Those who are English speaking (RR = 0.05, p < 0.0001), identify as visible minority Chinese (RR = 0.09, p = 0.0023) or visible minority South Asian (RR = 0.25, p = 0.015), and have a high median household income (RR = 0.27, p < 0.0001) have a significantly decreased relative risk of CMRSA10 infections.ConclusionsCMRSA10 prevalence increased between 2004 and 2007, followed by a stabilization of cases by 2014. Certain sociodemographic factors were protective from CMRSA10 infections. The model of MRSA population-surveillance and geomap outbreak events can be used to track the epidemiology of MRSA in any jurisdiction.
Highlights
The first Canadian outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-Methicillin-resistant Staphylococcus aureus (MRSA)) was identified in 2004 in Calgary, Alberta
The first outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in Canada was due to the CMRSA10 clone, and was documented in the Calgary Health Region in 2004, when physicians at a local corrections facility noticed an increase in soft tissue infections [5]
Using Statistics Canada’s census data, CA-MRSA had a prevalence of 4.8 cases/100000 population in 2004, and rose rapidly to 53.19/100000 in 2007, followed by stabilizing to 44.3/100000 by 2014
Summary
The first Canadian outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified in 2004 in Calgary, Alberta. Methicillin-resistant Staphylococcus aureus (MRSA) was initially associated with infections acquired in hospital and healthcare environments. CA-MRSA has subsequently become the leading manifestation of MRSA infection [2], occurring in many hospital and community settings [1]. Despite having less resistance to other antimicrobial classes than hospital-associated MRSA (HA-MRSA) [3], CA-MRSA has been able to colonize and infect humans effectively, leading to it becoming the dominant S. aureus strain in multiple settings [4]. The first outbreak of CA-MRSA in Canada was due to the CMRSA10 clone, and was documented in the Calgary Health Region in 2004, when physicians at a local corrections facility noticed an increase in soft tissue infections [5]. It was reported that individuals with a history of illicit drug use, homelessness or recent incarceration were associated with highest risk of infection and accounted for 70% of cases [5]
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