Epidemiology and Infection

Bacterial infections/HAI

Risk factors for community-associated Staphylococcus aureus infections: results from parallel studies including methicillin-resistant and methicillin-sensitive S. aureus compared to uninfected controls

K. J. COMO-SABETTIa1 c1, K. H. HARRIMANa1, S. K. FRIDKINa2, S. L. JAWAHIRa3 and R. LYNFIELDa1

a1 Infectious Disease Epidemiology, Prevention and Control Section, Minnesota Department of Health, Saint Paul, MN, USA

a2 Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA

a3 Public Health Laboratory, Minnesota Department of Health, MN, USA

SUMMARY

Despite the increasing burden of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections, the risk factors are not well understood. We conducted a hypothesis-generating study using three parallel case-control studies to identify risk factors for CA-MRSA and community-associated methicillin-susceptible S. aureus (CA-MSSA) infections. In the multivariate model, antimicrobial use in the 1–6 months prior to culture was associated with CA-MRSA infection compared to CA-MSSA [adjusted odds ratio (aOR) 1·7, P=0·07] cases. Antimicrobial use 1–6 months prior to culture (aOR 1·8, P=0·04), history of boils (aOR 1·6, P=0·03), and having a household member who was a smoker (aOR 1·3, P=0·05) were associated with CA-MRSA compared to uninfected community controls. The finding of an increased risk of CA-MRSA infection associated with prior antimicrobial use highlights the importance of careful antimicrobial stewardship.

(Accepted April 20 2010)

(Online publication June 01 2010)

Correspondence:

c1 Author for correspondence: K. J. Como-Sabetti, M.P.H., Infectious Disease Epidemiology, Prevention and Control, Minnesota Department of Health, Orville L. Freeman Building, 625 Robert St. N, PO Box 64975, St. Paul, MN 55164-0975, USA. (Email: kathy.como-sabetti@state.mn.us)

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