Emergence of community-acquired methicillin-resistant Staphylococcus aureus skin and soft tissue infections as a common cause of hospitalization in United States children

Chris Frei, Brittany R. Makos, Kelly R. Daniels, Christine U. Oramasionwu

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was first observed in pediatric patients in the late 1990s. Since then, possible risk factors for contracting CA-MRSA have been hypothesized, but supporting studies are limited. Methods: We analyzed hospital discharge records for patients with a principal International Classification of Diseases, Ninth Revision code for skin and soft tissue infections, collected from 1996 to 2006 by the United States National Center for Health Statistics. Noninstitutional, short-stay hospitals in the United States participated. The sample was limited to patients aged ≤19 years. Staphylococcus aureus and CA-MRSA were defined by International Classification of Diseases, Ninth Revision codes. Data weights were used to derive regional and national estimates. Population estimates were obtained from the US Bureau of the Census, and incidence rates were reported per 100,000 persons. Risk factors for CA-MRSA were first identified using χ2 and χ2 goodness-of-fit tests, then by multivariable logistic regression. Results: These data represent 616,375 pediatric discharges for skin and soft tissue infections from U.S. hospitals between 1996 and 2006. This represents approximately 69.9 hospitalizations for skin and soft tissue infections per 100,000 U.S. children per year. Staphylococcus aureus and CA-MRSA accounted for 19.6% and 9.6% of these cases, respectively. The rate of hospitalization for CA-MRSA skin and soft tissue infections increased dramatically over the study period; from less than one case per 100,000 in 1996 to 25.5 cases per 100,000 in 2006. Rates of CA-MRSA varied by region, with the South region having the highest rate (11.5 per 100,000 US children), followed by the West (5.2), Northeast (3.4), and Midwest (3.2). Peak CA-MRSA incidence occurred from May to December; however, the incidence in the South region was consistently higher than other regions for most months and the period of peak incidence was longer than other regions. Independent risk factors for CA-MRSA included survey year, race, geographic region, hospital size, and health insurance status (P < .0001 for all risk factors). Conclusions: Pediatric hospitalizations for methicillin-susceptible S. aureus and CA-MRSA skin and soft tissue infections are on the rise. Possible risk factors for CA-MRSA infection include White race, residence in the South region of the United States, and lack of health insurance.

Original languageEnglish (US)
Pages (from-to)1967-1974
Number of pages8
JournalJournal of Pediatric Surgery
Volume45
Issue number10
DOIs
StatePublished - Oct 2010

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Soft Tissue Infections
Methicillin-Resistant Staphylococcus aureus
Hospitalization
Skin
Staphylococcus aureus
Incidence
International Classification of Diseases
Health Insurance
Pediatrics
Health Facility Size
National Center for Health Statistics (U.S.)
Methicillin
Insurance Coverage
Hospital Records
Patient Discharge
Censuses
Health Status
Length of Stay
Logistic Models

Keywords

  • MRSA
  • Pediatric infections
  • Skin and soft tissue infections

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Emergence of community-acquired methicillin-resistant Staphylococcus aureus skin and soft tissue infections as a common cause of hospitalization in United States children. / Frei, Chris; Makos, Brittany R.; Daniels, Kelly R.; Oramasionwu, Christine U.

In: Journal of Pediatric Surgery, Vol. 45, No. 10, 10.2010, p. 1967-1974.

Research output: Contribution to journalArticle

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abstract = "Background: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was first observed in pediatric patients in the late 1990s. Since then, possible risk factors for contracting CA-MRSA have been hypothesized, but supporting studies are limited. Methods: We analyzed hospital discharge records for patients with a principal International Classification of Diseases, Ninth Revision code for skin and soft tissue infections, collected from 1996 to 2006 by the United States National Center for Health Statistics. Noninstitutional, short-stay hospitals in the United States participated. The sample was limited to patients aged ≤19 years. Staphylococcus aureus and CA-MRSA were defined by International Classification of Diseases, Ninth Revision codes. Data weights were used to derive regional and national estimates. Population estimates were obtained from the US Bureau of the Census, and incidence rates were reported per 100,000 persons. Risk factors for CA-MRSA were first identified using χ2 and χ2 goodness-of-fit tests, then by multivariable logistic regression. Results: These data represent 616,375 pediatric discharges for skin and soft tissue infections from U.S. hospitals between 1996 and 2006. This represents approximately 69.9 hospitalizations for skin and soft tissue infections per 100,000 U.S. children per year. Staphylococcus aureus and CA-MRSA accounted for 19.6{\%} and 9.6{\%} of these cases, respectively. The rate of hospitalization for CA-MRSA skin and soft tissue infections increased dramatically over the study period; from less than one case per 100,000 in 1996 to 25.5 cases per 100,000 in 2006. Rates of CA-MRSA varied by region, with the South region having the highest rate (11.5 per 100,000 US children), followed by the West (5.2), Northeast (3.4), and Midwest (3.2). Peak CA-MRSA incidence occurred from May to December; however, the incidence in the South region was consistently higher than other regions for most months and the period of peak incidence was longer than other regions. Independent risk factors for CA-MRSA included survey year, race, geographic region, hospital size, and health insurance status (P < .0001 for all risk factors). Conclusions: Pediatric hospitalizations for methicillin-susceptible S. aureus and CA-MRSA skin and soft tissue infections are on the rise. Possible risk factors for CA-MRSA infection include White race, residence in the South region of the United States, and lack of health insurance.",
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T1 - Emergence of community-acquired methicillin-resistant Staphylococcus aureus skin and soft tissue infections as a common cause of hospitalization in United States children

AU - Frei, Chris

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AU - Oramasionwu, Christine U.

PY - 2010/10

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N2 - Background: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was first observed in pediatric patients in the late 1990s. Since then, possible risk factors for contracting CA-MRSA have been hypothesized, but supporting studies are limited. Methods: We analyzed hospital discharge records for patients with a principal International Classification of Diseases, Ninth Revision code for skin and soft tissue infections, collected from 1996 to 2006 by the United States National Center for Health Statistics. Noninstitutional, short-stay hospitals in the United States participated. The sample was limited to patients aged ≤19 years. Staphylococcus aureus and CA-MRSA were defined by International Classification of Diseases, Ninth Revision codes. Data weights were used to derive regional and national estimates. Population estimates were obtained from the US Bureau of the Census, and incidence rates were reported per 100,000 persons. Risk factors for CA-MRSA were first identified using χ2 and χ2 goodness-of-fit tests, then by multivariable logistic regression. Results: These data represent 616,375 pediatric discharges for skin and soft tissue infections from U.S. hospitals between 1996 and 2006. This represents approximately 69.9 hospitalizations for skin and soft tissue infections per 100,000 U.S. children per year. Staphylococcus aureus and CA-MRSA accounted for 19.6% and 9.6% of these cases, respectively. The rate of hospitalization for CA-MRSA skin and soft tissue infections increased dramatically over the study period; from less than one case per 100,000 in 1996 to 25.5 cases per 100,000 in 2006. Rates of CA-MRSA varied by region, with the South region having the highest rate (11.5 per 100,000 US children), followed by the West (5.2), Northeast (3.4), and Midwest (3.2). Peak CA-MRSA incidence occurred from May to December; however, the incidence in the South region was consistently higher than other regions for most months and the period of peak incidence was longer than other regions. Independent risk factors for CA-MRSA included survey year, race, geographic region, hospital size, and health insurance status (P < .0001 for all risk factors). Conclusions: Pediatric hospitalizations for methicillin-susceptible S. aureus and CA-MRSA skin and soft tissue infections are on the rise. Possible risk factors for CA-MRSA infection include White race, residence in the South region of the United States, and lack of health insurance.

AB - Background: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) was first observed in pediatric patients in the late 1990s. Since then, possible risk factors for contracting CA-MRSA have been hypothesized, but supporting studies are limited. Methods: We analyzed hospital discharge records for patients with a principal International Classification of Diseases, Ninth Revision code for skin and soft tissue infections, collected from 1996 to 2006 by the United States National Center for Health Statistics. Noninstitutional, short-stay hospitals in the United States participated. The sample was limited to patients aged ≤19 years. Staphylococcus aureus and CA-MRSA were defined by International Classification of Diseases, Ninth Revision codes. Data weights were used to derive regional and national estimates. Population estimates were obtained from the US Bureau of the Census, and incidence rates were reported per 100,000 persons. Risk factors for CA-MRSA were first identified using χ2 and χ2 goodness-of-fit tests, then by multivariable logistic regression. Results: These data represent 616,375 pediatric discharges for skin and soft tissue infections from U.S. hospitals between 1996 and 2006. This represents approximately 69.9 hospitalizations for skin and soft tissue infections per 100,000 U.S. children per year. Staphylococcus aureus and CA-MRSA accounted for 19.6% and 9.6% of these cases, respectively. The rate of hospitalization for CA-MRSA skin and soft tissue infections increased dramatically over the study period; from less than one case per 100,000 in 1996 to 25.5 cases per 100,000 in 2006. Rates of CA-MRSA varied by region, with the South region having the highest rate (11.5 per 100,000 US children), followed by the West (5.2), Northeast (3.4), and Midwest (3.2). Peak CA-MRSA incidence occurred from May to December; however, the incidence in the South region was consistently higher than other regions for most months and the period of peak incidence was longer than other regions. Independent risk factors for CA-MRSA included survey year, race, geographic region, hospital size, and health insurance status (P < .0001 for all risk factors). Conclusions: Pediatric hospitalizations for methicillin-susceptible S. aureus and CA-MRSA skin and soft tissue infections are on the rise. Possible risk factors for CA-MRSA infection include White race, residence in the South region of the United States, and lack of health insurance.

KW - MRSA

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KW - Skin and soft tissue infections

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