Infection Control & Hospital Epidemiology

Original Articles

Trends in Hospitalization for Community-Associated Methicillin-Resistant Staphylococcus aureus in New York City, 1997–2006: Data from New York State's Statewide Planning and Research Cooperative System

Amanda M. Farra1 c1, Brandon Adena2, Don Weissa3, Denis Nasha4 and Melissa A. Marxa5

a1 Custom Data Analytics, Thomson Reuters, Washington, DC

a2 Department of Public Health, Weill Cornell Medical College, New York, New York

a3 Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, New York, New York

a4 Epidemiology and Biostatistics Program, Hunter College School of Public Health, New York, New York

a5 Global AIDS Program, Centers for Disease Control and Prevention, Lukasa, Zambia

Abstract

Objective. To describe trends in hospitalizations with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection in New York City over 10 years and to explore the demographics and comorbidities of patients hospitalized with CA-MRSA infections.

Design. Retrospective analysis of hospital discharges from New York State's Statewide Planning and Research Cooperative System database from 1997 to 2006.

Patients. All patients greater than 1 year of age admitted to New York hospitals with diagnosis codes indicating MRSA who met the criteria for CA-MRSA on the basis of admission information and comorbidities.

Methods. We determined hospitalization rates and compared demographics and comorbidities of patients hospitalized with CA-MRSA versus those hospitalized with all other non-MRSA diagnoses by multivariable logistic regression.

Results. Of 18,226 hospitalizations with an MRSA diagnosis over 10 years, 3,579 (20%) were classified as community-associated. The CA-MRSA hospitalization rate increased from 1.47 to 10.65 per 100,000 people overall from 1997 to 2006. Relative to non-MRSA hospitalizations, men, children, Bronx and Manhattan residents, the homeless, patients with human immunodeficiency virus (HIV) infection, and persons with diabetes had higher adjusted odds of CA-MRSA hospitalization.

Conclusions. The CA-MRSA hospitalization rate appeared to increase between 1997 and 2006 in New York City, with residents of the Bronx and Manhattan, men, and persons with HIV infection or diabetes at increased odds of hospitalization with CA-MRSA. Further studies are needed to explore how changes in MRSA incidence, access to care, and other factors may have impacted these rates.

(Received November 12 2011)

(Accepted February 05 2012)

Correspondence

c1 420 Whitney Avenue, Apt 12, New Haven, CT 06511 (Amanda.Farr@thomsonreuters.com)