Volume 25, Number 1—January 2019
Dispatch
Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA
, Dave Boxrud, Ginette Dobbins, Anita Glennen, Melissa Anacker, Selina Jawahir, Isaac See, and Ruth Lynfield
Table 1
Epidemiologic characteristics and concurrent conditions for patients with cases of invasive MSSA and MRSA, Minnesota, USA, August 1, 2014–July 31, 2015*
| Characteristic | Total, n = 701 |
HO, n = 65 |
HACO, n = 416 |
CA, n = 220 |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MSSA | MRSA | p value | MSSA | MRSA | p value | MSSA | MRSA | p value | MSSA | MRSA | p value | ||||
| Total |
473 (67) |
228 (33) |
NA |
40 (8) |
25 (11) |
0.28 |
260 (55) |
156 (68) |
<0.001 |
173 (37) |
47 (21) |
<0.01 |
|||
| Demographic | |||||||||||||||
| Median age, y | 59 (0–102) | 62 (0–95) | 0.05 | 61 (0–94) | 61 (17–93) | 0.99 | 62 (0–102) | 65 (5–95) | 0.21 | 55 (0–90) | 50 (0–91) | 0.40 | |||
| Sex | |||||||||||||||
| F | 175 (37) | 92 (40) | 0.39 | 15 (38) | 6 (24) | 0.26 | 108 (42) | 66 (42) | 0.88 | 52 (30) | 20 (43) | 0.11 | |||
| M | 316 (67) | 153 (67) | 0.94 | 26 (65) | 13 (52) | 0.30 | 169 (65) | 109 (70) | 0.31 | 121 (70) | 31 (66) | 0.60 | |||
| Private residence 4 d before culture | 376 (79) | 146 (64) | <0.01 | NA | NA | NA | 211 (81) | 100 (64) | <0.01 | 165 (95) | 46 (98) | 0.69 | |||
| LTCF past year | 53 (11) | 70 (31) | <0.01 | 4 (10) | 8 (32) | 0.05 | 49 (19) | 62 (40) | <0.01 | NA | NA | NA | |||
| CVC 2 d before culture | 29 (6) | 19 (8) | 0.28 | 6 (15) | 5 (20) | 0.74 | 23 (9) | 14 (9) | 0.97 | NA | NA | NA | |||
| Length of stay, d | 7 (0–121) | 8 (0–58) | 0.05 | 15 (3–121) | 15 (4–48) | 0.91 | 6 (0–43) | 7 (1–39) | 0.11 | 7 (0–53) | 9 (0–58) | 0.15 | |||
| Inpatient death |
47 (10) |
26 (11) |
0.55 |
8 (20) |
2 (8) |
0.29 |
29 (11) |
23 (15) |
0.28 |
10 (6) |
1 (2) |
0.46 |
|||
| Concurrent condition | |||||||||||||||
| None | 96 (20) | 27 (12) | <0.01 | 1 (4) | 5 (13) | 0.39 | 14 (9) | 35 (12) | 0.17 | 12 (26) | 56 (12) | 0.37 | |||
| Kidney disease | 95 (20) | 67 (29) | <0.01 | 9 (23) | 9 (36) | 0.24 | 77 (30) | 54 (35) | 0.29 | 9 (5) | 4 (9) | 0.48 | |||
| Chronic skin breakdown | 22 (5) | 25 (11) | <0.01 | <0.01 | 3 (12) | 0.69 | 14 (5) | 21 (13) | <0.01 | 5 (3) | 1 (2) | 1.00 | |||
| D/PU | 9 (2) | 17 (7) | <0.01 | 0 (0) | 0 (0) | NA | 6 (2) | 17 (11) | <0.01 | 3 (2) | 0 (0) | 1.00 | |||
| CVD | 58 (12) | 46 (20) | <0.01 | 5 (13) | 6 (24) | 0.31 | 44 (17) | 39 (25) | 0.05 | 9 (5) | 1 (2) | 0.69 | |||
| H/P | 15 (3) | 23 (10) | <0.01 | 1 (3) | 2 (8) | 0.55 | 9 (3) | 20 (13) | <0.01 | 5 (3) | 1 (2) | 1.00 | |||
| Other drug use† | 41 (9) | 25 (11) | 0.33 | 4 (10) | 2 (8) | 1.00 | 21 (8) | 11 (7) | 0.70 | 16 (9) | 12 (26) | <0.01 | |||
| PVD | 24 (5) | 22 (10) | 0.02 | 3 (8) | 4 (16) | 0.42 | 16 (6) | 17 (11) | 0.08 | 5 (3) | 1 (2) | 1.00 | |||
| COPD | 50 (11) | 34 (15) | 0.10 | 6 (15) | 6 (24) | 0.36 | 30 (12) | 23 (15) | 0.34 | 14 (8) | 5 (11) | 0.57 | |||
| Current smoker | 71 (15) | 32 (14) | 0.73 | 7 (18) | 4 (16) | 1.00 | 36 (14) | 19 (12) | 0.63 | 28 (16) | 9 (19) | 0.63 | |||
| Diabetes | 153 (32) | 80 (35) | 0.47 | 12 (30) | 11 (44) | 0.25 | 96 (37) | 59 (38) | 0.86 | 45 (26) | 10 (21) | 0.51 | |||
| Injection drug use | 25 (5) | 12 (5) | 0.99 | 0 (0) | 0 (0) | NA | 10 (4) | 4 (3) | 0.48 | 15 (9) | 8 (17) | 0.11 | |||
| Obesity |
70 (15) |
43 (19) |
0.17 |
8 (20) |
7 (28) |
0.46 |
47 (18) |
29 (19) |
0.90 |
15 (9) |
7 (15) |
0.27 |
|||
| Syndrome | |||||||||||||||
| Bacteremia | 328 (69) | 178 (78) | 0.03 | 30 (75) | 16 (64) | 0.34 | 181 (70) | 125 (80) | 0.03 | 117 (68) | 37 (79) | 0.14 | |||
| Internal abscess | 25 (5) | 11 (5) | 0.78 | 2 (5) | 0 (0) | 0.52 | 16 (6) | 5 (3) | 0.18 | 7 (4) | 6 (13) | 0.04 | |||
| Pneumonia‡ | 39 (8) | 40 (18) | <0.01 | 2 (5) | 8 (32) | <0.01 | 21 (8) | 22 (14) | 0.06 | 16 (9) | 10 (21) | 0.02 | |||
| Septic arthritis | 137 (29) | 35 (15) | <0.01 | 3 (8) | 2 (8) | 1.00 | 67 (26) | 24 (15) | 0.01 | 67 (39) | 9 (19) | 0.01 | |||
| Skin abscess | 7 (1) | 4 (2) | 0.76 | 0 (0) | 1 (4) | 0.39 | 7 (3) | 0 (0) | 0.05 | 0 (0) | 3 (6) | <0.01 | |||
| Bursitis | 35 (7) | 10 (4) | 0.12 | 0 (0) | 1 (4) | 0.39 | 7 (3) | 3 (2) | 0.75 | 28 (16) | 6 (13) | 0.57 | |||
| Cellulitis | 73 (15) | 32 (14) | 0.60 | 6 (15) | 3 (12) | 1.00 | 38 (15) | 18 (11) | 0.35 | 29 (17) | 11 (23) | 0.30 | |||
| Endocarditis | 23 (5) | 9 (4) | 0.57 | 2 (5) | 1 (4) | 1.00 | 12 (5) | 5 (3) | 0.47 | 9 (5) | 3 (6) | 0.72 | |||
| Osteomyelitis | 51 (11) | 28 (12) | 0.58 | 1 (3) | 4 (16) | 0.07 | 38 (15) | 20 (13) | 0.58 | 12 (7) | 3 (7) | 0.75 | |||
| Septic shock | 41 (9) | 19 (8) | 0.86 | 3 (8) | 4 (16) | 0.42 | 27 (10) | 11 (7) | 0.24 | 11 (6) | 4 (9) | 0.53 | |||
*Values are no. (%), median (range), or no. (range). Nonsignificant (p>0.05) differences were observed for chronic pulmonary disease, current smoker, diabetes, intravenous drug use, obesity, bursitis, cellulitis, endocarditis, osteomyelitis, and septic shock among patients with MSSA and MRSA cases and within epidemiologic classifications of MSSA and MRSA cases. CA, community associated; COPD, chronic pulmonary disease; CVC, central venous catheter; CVD, cardiovascular disease; D/PU, decubitus/pressure ulcer; HACO, healthcare-associated, community onset; HO, hospital onset; H/P, hemiplagia/paraplegia; LTCF, long-term care facility; MRSA, methicillin-resistant Staphylococcus aureus; MSSA, methicillin-susceptible S. aureus; NA, not available; PVD, peripheral vascular disease.
†Drug use other than intravenous drug use.
‡All patients with pneumonia had positive blood cultures to meet the case definition.