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Volume 25, Number 1—January 2019
Dispatch

Burdens of Invasive Methicillin-Susceptible and Methicillin-Resistant Staphylococcus aureus Disease, Minnesota, USA

Mackenzie Koeck, Kathryn Como-SabettiComments to Author , Dave Boxrud, Ginette Dobbins, Anita Glennen, Melissa Anacker, Selina Jawahir, Isaac See, and Ruth Lynfield
Author affiliations: Minnesota Department of Health, St. Paul, Minnesota, USA (M. Koeck, K. Como-Sabetti, D. Boxrud, G. Dobbins, A. Glennen, M. Anacker, S. Jawahir, R. Lynfield); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. See)

Main Article

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.

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Page created: December 18, 2018
Page updated: December 18, 2018
Page reviewed: December 18, 2018
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