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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 2

Descriptive epidemiology of invasive MRSA in Iowa, USA, 2006*

Characteristic† Total no. (%), N = 343 USA type
p value
No. (%) USA300/400, n = 54 No. (%) other,‡ n = 289
Mean age, y 66.3 (SD = 17.0) 50.6 (SD = 21.2) 69.2 (SD = 14.4) <0.0001
Female gender 135 (39.4) 14 (25.9) 121 (41.9) 0.059
Inpatient stay 278 (81.0) 50 (92.6) 228 (78.9) 0.271
ICU admission 56 (16.3) 8 (14.8) 48 (16.7) 0.348
Nosocomial infection
57 (16.6)
1 (1.9)
56 (19.4)
0.0006
Specimen type 0.0021
Blood 322 (93.9) 45 (83.3) 276 (95.0)
CSF 0 0 0
Joint fluid 13 (3.8) 5 (9.3) 8 (2.9)
Pleural fluid 2 (0.6) 2 (3.7) 0
Other
6 (1.7)
2 (3.7)
5 (1.4)

Iowa region 0.268
1 10 (2.9) 0 10 (3.5)
2 93 (27.0) 13 (24.1) 80 (27.7)
3 49 (14.2) 12 (22.2) 37 (12.8)
4 105 (30. 5) 16 (29.6) 88 (30.5)
6
20 (5.8)
5 (9.3)
15 (5.2)

PVL
54 (15.7)
52 (96.3)
2 (0.7)§
<0.0001
SCCmec IV 68 (19.8) 54 (100.0) 13 (4.5) <0.0001

*MRSA, methicillin-resistant Staphylococcus aureus; ICU, intensive care unit; CSF, cerebrospinal fluid; PVL, Panton-Valentine leukocidin; SCCmec IV, Staphylococcal chromosomal cassette mec type IV.
†The number of patients missing data on specific variables: age = 10; gender = 12; inpatient = 31; ICU = 122; nosocomial = 101; specimen type = 0; Iowa Department of Public Health Reporting Region = 6; PVL = 3; SCCmec IV = 3.
‡Of the subset of isolates that were typed (N = 272) 94% were USA100. The remainder clustered with USA200 (5), USA500 (5), USA600 (1), USA800 (4), or did not match an existing USA type.
§Both isolates clustered with USA100 and were SCCmecII.

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