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Volume 16, Number 2—February 2010

Research

Imported Methicillin-Resistant Staphylococcus aureus, Sweden

Mikael StenhemComments to Author , Åke Örtqvist, Håkan Ringberg, Leif Larsson, Barbro Olsson-Liljequist, Sara Hæggman, Mats Kalin, and Karl Ekdahl
Author affiliations: Swedish Institute for Infectious Disease Control, Solna, Sweden (M. Stenhem, B. Olsson-Liljequist, S. Hæggman); Karolinska Institutet, Solna (M. Stenhem, Å. Örtqvist, M. Kalin, K. Ekdahl); County Medical Office Communicable Disease Control, Stockholm, Sweden (Å. Örtqvist); Regional Centre for Communicable Disease Control and Prevention, Malmö, Sweden (H. Ringberg); Sahlgrenska University Hospital, Göteborg, Sweden (L. Larsson); European Centre for Disease Prevention and Control, Solna (K. Ekdahl)

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Table 1

Estimated number of travelers and cases of travel-associated acquisition of MRSA, Sweden, 2000–2003*

Variable Estimated no. travelers No. with MRSA infection (no. with MRSA disease) Crude risk/1 million travelers (95% CI) % Community-acquired cases Adjusted OR 
(95% CI)
Sex
F 25,219,000 109 (62) 4.3 (3.6–5.2) 42.2 Reference
M
20,634,000
158 (71)
7.7 (6.6–8.9)
27.2
1.5 (1.2–2.0)
Age group, y
0–14 6,497,000 30 (24) 4.6 (3.2–6.6) 83.3 Reference
15–29 8,657,000 72 (36) 8.3 (6.6–10) 31.9 1.0 (0.6–1.5)
30–44 13,234,000 49 (26) 3.7 (2.8–4.9) 44.9 0.8 (0.5–1.3)
45–59 12,342,000 62 (29) 5.0 (3.9–6.4) 22.6 0.8 (0.5–1.2)
60–74
5,127,000
54 (18)
11 (8.1–13.8)
9.3
1.2 (0.7–1.9)
Purpose of travel
Leisure 36,323,000 237 (123) 6.5 (5.7–7.4) 34.2 Reference
Work
9,532,000
30 (10)
3.1 (2.2–4.5)
26.7
2.4 (1.5–3.8)
Region of origin†
Nordic 15,962,000 1 (0) 0.1 (0.01–0.4) 0.0 0.1 (0.01–0.6)
Western Europe 7,614,000 7 (3) 0.9 (0.4–1.9) 14.3 Reference
Southern Europe 7,601,000 18 (5) 2.4 (1.5–3.8) 0.0 2.4 (1.0–5.8)
Central and Eastern Europe 2,885,000 7 (5) 2.4 (1.2–5.1) 28.6 2.8 (1.0–8.1)
UK and Ireland 2,815,000 26 (11) 9.2 (6.3–13.6) 7.7 10.3 (4.4–24..0)
North America 1,627,000 17 (4) 10.4 (6.5–16.8) 35.3 10.6 (4.2–26.7)
Northeastern Mediterranean 4,317,000 63 (30) 14.6 (11.4–18.7) 38.1 15.8 (7.0–35.6)
South America 152,000 6 (5) 39.5 (17.7–87.9) 33.3 31.2 (10.0–97.6)
East Asia 1,622,000 54 (27) 33.3 (25.5–43.5) 27.8 36.5 (16.2–82.0)
Oceania and Pacific Islands 250,000 11 (5) 44.0 (24.4–79.5) 36.4 43.0 (15.5–119.4)
Sub-Saharan Africa 232,000 11 (7) 47.4 (26.3–85.6) 54.5 46.3 (17.3–123.6)
North Africa and Middle East
774,000
46 (31)
59.4 (44.5–79.3)
58.7
59.0 (25.1–138.9)
Total 45,855,000 267 (133) 5.8 (5.2–6.6) 33.3

*MRSA, methicillin-resistant Staphylococcus aureus; CI, confidence interval; OR, odds ratio.
†Nordic: Denmark, Finland, Iceland, Norway; Western Europe: Austria, Belgium, France, Germany, Luxembourg, the Netherlands, Switzerland; Southern Europe: Italy, Malta, Monaco, Portugal, Spain; Central and Eastern Europe: Belarus, Bulgaria, Estonia, Hungary, Kazakhstan, Latvia, Lithuania, Poland, Romania, Russia, Slovakia, Czech Republic, Ukraine; North America: Canada, Cuba, Dominican Republic, Guadeloupe, Guatemala, Mexico, Panama, United States; Northeastern Mediterranean: Albania, Bosnia-Herzegovina, Cyprus, former Yugoslavia, Greece, Croatia, Macedonia, Serbia, Slovenia, Turkey; South America: Brazil, Chile, Colombia, Ecuador, Peru, Venezuela; East Asia: Afghanistan, Bangladesh, Cambodia, China, Hong Kong, India, Indonesia, Japan, South Korea, Malaysia, Maldives, Mongolia, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand, Vietnam, the Philippines; Oceania and Pacific islands: Australia, Hawaii, New Zealand, Samoa; Sub-Saharan Africa: Angola, Botswana, Chad, Ethiopia, the Gambia, Ghana, Kenya, Congo–Kinshasa, Madagascar, Senegal, Sierra Leone–Togo, Somalia, Sudan, Swaziland, South Africa, Tanzania–Uganda; North Africa and Middle East: Algeria, Egypt, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Libya, Morocco, Saudi Arabia, Syria, Tunisia, United Arab Emirates.

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