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Volume 15, Number 10—October 2009

CME ACTIVITY

Community-Associated Methicillin-Resistant Staphylococcus aureus, Iowa, USA

Philip Van De Griend, Loreen A. HerwaldtComments to Author , Bret Alvis, Mary DeMartino, Kristopher Heilmann, Gary Doern, Patricia Winokur, Diana DeSalvo Vonstein, and Daniel Diekema
Author affiliations: The University of Iowa Carver College of Medicine, Iowa City, Iowa, USA (P. Van De Griend, L.A. Herwaldt, B. Alvis, K. Heilmann, G. Doern, P. Winokur, D. Diekema); The University of Iowa Hygienic Lab, Iowa City (M. DeMartino); The University of Iowa College of Public Health, Iowa City (L.A. Herwaldt); The University of Iowa Hospitals and Clinics, Iowa City (L.a. Herwaldt, D. Diekema); The Iowa City Veterans Administration Medical Center, Iowa City (P. Winokur, D.D. Vonstein, D. Diekema)

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Table 1

Descriptive epidemiology of invasive MRSA in Iowa, USA, 1999–2005*

Characteristic† Total no. (%), N = 1,323 USA type
p value
No. (%) USA300/400, n = 26 No. (%) other,‡ n = 1,297
Mean age, y 67.8 (SD = 17.6) 46.0 (SD = 22.0) 68.2 (SD = 17.2) <0.0001
Female gender 550 (41.6) 9 (34.6) 541 (42.7) 0.549
Inpatient stay 1,124 (85.0) 24 (92.3) 1,100 (84.8) 1.000
ICU admission 221 (16.7) 4 (15.4) 217 (16.7) 0.764
Nosocomial infection
346 (26.2)
5 (19.2)
341 (26.3)
0.306
Specimen type <0.0001
Blood 1,256 (94.9) 25 (96.2) 1,231 (94.9)
CSF 9 (0.7) 0 9 (0.7)
Joint fluid 33 (2.5) 1 (3.9) 32 (2.5)
Pleural fluid 8 (0.6) 0 8 (0.6)
Other
6 (0.5)
0 (0.0)
6 (0.5)

Iowa region 0.054
1 32 (2.4) 1 (3.9) 31 (2.4)
2 370 (28.0) 10 (38.5) 360 (27.8)
3 335 (25.3) 2 (7.7) 333 (25.7)
4 272 (20.6) 4 (15.4) 268 (20.7)
5 140 (10.6) 5 (19.2) 135 (10.4)
6
63 (4.8)
4 (15.4)
59 (4.5)

PVL
ND
ND
ND
ND
SCCmec IV ND ND ND ND

*MRSA, methicillin-resistant Staphylococcus aureus; ICU, intensive care unit; CSF, cerebrospinal fluid; PVL, Panton-Valentine leukocidin; SCCmec IV, staphylococcal chromosomal cassette mec type IV; ND, not done for all isolates.
†The number of patients missing data on specific variables: age = 13; gender = 11; inpatient = 85; ICU = 356; nosocomial = 358; specimen type = 11; Iowa Department of Public Health Reporting Region = 11.
‡Of the subset of isolates that were typed (N = 180), 173 (96%) were USA100. The remainder clustered with USA200 (3), USA500 (2), or did not match an existing USA type.

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