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Spatial Analysis of Community-Onset Staphylococcus aureus Bacteremia in Queensland, Australia

Published online by Cambridge University Press:  02 January 2015

John Marquess ,
Wenbiao Hu ,
Graeme R. Nimmo  and
Archie C. A. Clements
John Marquess*
Affiliation:
Centre for Healthcare Related Infection Surveillance and Prevention, Herston, Brisbane, Queensland, Australia University of Queensland, Infectious Disease Epidemiology Unit, School of Population Health, Herston, Brisbane, Queensland, Australia
Wenbiao Hu
Affiliation:
University of Queensland, Infectious Disease Epidemiology Unit, School of Population Health, Herston, Brisbane, Queensland, Australia
Graeme R. Nimmo
Affiliation:
Pathology Queensland Central Laboratory, Herston, Brisbane, Queensland, Australia Griffith University School of Medicine, Gold Coast, Queensland, Australia
Archie C. A. Clements
Affiliation:
University of Queensland, Infectious Disease Epidemiology Unit, School of Population Health, Herston, Brisbane, Queensland, Australia
*
Centre for Healthcare Related Infection Surveillance and Prevention, Chief Health Officer Branch, 15 Butterfield Street, Herston, Brisbane QLD 4006, Australia
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Abstract

Objectives.

TO investigate and describe the relationship between indigenous Australian populations, residential aged care services, and community-onset Staphylococcus aureus bacteremia (SAB) among patients admitted to public hospitals in Queensland, Australia.

Design.

Ecological study.

Methods.

We used administrative healthcare data linked to microbiology results from patients with SAB admitted to Queensland public hospitals from 2005 through 2010 to identify community-onset infections. Data about indigenous Australian population and residential aged care services at the local government area level were obtained from the Queensland Office of Economic and Statistical Research. Associations between community-onset SAB and indigenous Australian population and residential aged care services were calculated using Poisson regression models in a Bayesian framework. Choropleth maps were used to describe the spatial patterns of SAB risk.

Results.

We observed a 21% increase in relative risk (RR) of bacteremia with methicillin-susceptible S. aureus (MSSA; RR, 1.21 [95% credible interval, 1.15–1.26]) and a 24% increase in RR with nonmultiresistant methicillin-resistant S. aureus (nmMRSA; RR, 1.24 [95% credible interval, 1.13–1.34]) with a 10% increase in the indigenous Australian population proportion. There was no significant association between RR of SAB and the number of residential aged care services. Areas with the highest RR for nmMRSA and MSSA bacteremia were identified in the northern and western regions of Queensland.

Conclusions.

The RR of community-onset SAB varied spatially across Queensland. There was increased RR of community-onset SAB with nmMRSA and MSSA in areas of Queensland with increased indigenous population proportions. Additional research should be undertaken to understand other factors that increase the risk of infection due to this organism.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 3 , March 2013 , pp. 291 - 298
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1. Kluytmans, J, van Belkum, A, Verbrugh, H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10(3):505–520.Google Scholar
2. Chambers, HF, Deleo, FR. Waves of resistance: Staphylococcus aureus in the antibiotic era. Nat Rev Microbiol 2009;7(9):629–641.Google Scholar
3. Udo, EE, Pearman, JW, Grubb, WB. Genetic analysis of community isolates of methicillin-resistant Staphylococcus aureus in Western Australia. J Hosp Infect 1993;25(2):97–108.Google Scholar
4. Coombs, GW, Nimmo, GR, Pearson, JC, et al. Prevalence of MRSA strains among Staphylococcus aureus isolated from outpatients, 2006.Commun Dis Intell 2009;33(1):10–20.Google Scholar
5. Gosbell, IB, Barbagiannakos, T, Neville, SA, et al. Non-multi-resistant methicillin-resistant Staphylococcus aureus bacteraemia in Sydney, Australia: emergence of EMRSA-15, Oceania, Queensland and Western Australian MRSA strains. Pathology 2006;38(3):239–244.Google Scholar
6. Munckhof, WJ, Nimmo, GR, Carney, J, et al. Methicillin-suscep-tible, non-multiresistant methicillin-resistant and multiresistant methicillin-resistant Staphylococcus aureus infections: a clinical, epidemiological and microbiological comparative study. Eur J Clin Microbiol Infect Dis 2008;27(5):355–364.Google Scholar
7. Nimmo, GR, Coombs, GW. Community-associated methicillin-resistant Staphylococcus aureus (MRSA) in Australia. Int J An-timicrob Agents 2008;31(5):401–410.CrossRefGoogle ScholarPubMed
8. Nimmo, GR, Fong, J, Paterson, DL, McLaws, ML. Changing epidemiology of methicillin-resistant S. aureus in Queensland, Australia, 2000-2006: use of passive surveillance of susceptibility phenotypes. J Hosp Infect 2008;70(4):305–313.Google Scholar
9. Nimmo, GR, Schooneveldt, JM, Sutherland, JL, et al. Epidemiology of non-multiresistant methicillin-resistant Staphylococcus aureus infection in Queensland, Australia: associations with indigenous populations and Panton-Valentine leukocidin. Eur J Clin Microbiol Infect Dis 2010;29(10):1253–1259.Google Scholar
10. Tong, SYC, McDonald, MI, Holt, DC, Currie, BJ. Global implications of the emergence of community-associated methicillin-resistant Staphylococcus aureus in indigenous populations. Clin Infect Dis 2008;46(12):1871–1878.Google Scholar
11. Turnidge, JD, Kotsanas, D, Munckhof, W, et al. Staphylococcus aureus bacteraemia: a major cause of mortality in Australia and New Zealand. Med J Australia 2009;191(7):368–373.Google Scholar
12. Richardson, S, Thomson, A, Best, N, Elliott, P. Interpreting posterior relative risk estimates in disease-mapping studies. Environ Health Perspect 2004;112(9):1016–1025.Google Scholar
13. Tong, SY, Bishop, EJ, Lilliebridge, RA, et al. Community-associated strains of methicillin-resistant Staphylococcus aureus and methi-cillin-susceptible S. aureus in indigenous northern Australia: epidemiology and outcomes. J Infect Dis 2009;199(10):1461–1470.Google Scholar
14. Vlack, S, Cox, L, Peleg, AY, et al. Carriage of methicillin-resistant Staphylococcus aureus in a Queensland indigenous community. Med J Aust 2006;184(11):556–559.Google Scholar
15. Briggs, S, McGuiness, C, Foster, M, Roberts, S. A reservoir for methicillin-resistant Staphylococcus aureus in the Auckland community? N Z Med 2002;115(1162):U182.Google Scholar
16. Drinka, PI, Stemper, ME, Gauerke, CD, Miller, JE, Reed, KD. Screening for methicillin-resistant Staphylococcus aureus in a nursing home. Infect Control Hosp Epidemiol 2004;25(2):95–96.Google Scholar
17. Lee, YL, Cesario, T, Gupta, G, et al. Surveillance of colonization and infection with Staphylococcus aureus susceptible or resistant to methicillin in a community skilled-nursing facility. Am J Infect Control 1997;25(4):312–321.Google Scholar
18. Australian Institute of Health and Welfare. Australia's Health 2010. Canberra, Australia: Australian Institute of Health and Welfare, 2010.Google Scholar
19. Office of Economic and Statistical Research, Queensland Treasury. Queensland Regional Profiles, http://statistics.oesr.qld.gov.au/qld-regional-profiles. Accessed June 18, 2011.Google Scholar
20. Waller, LA, Gotway, CA. Analyzing public health data. In: Applied Spatial Statistics for Public Health Data. Hoboken, NJ: Wiley, 2004:7–37.Google Scholar
21. Saigado, CD, Farr, BM, Calfee, DP. Community-acquired methicillin-resistant Staphylococcus aureus: a meta-analysis of prevalence and risk factors. Clin Infect Dis 2003;36(2):131–139.Google Scholar
22. Coombs, GW, Nimmo, GR, Bell, JM, et al. Genetic diversity among community methicillin-resistant Staphylococcus aureus strains causing outpatient infections in Australia. J Clin Microbiol 2004;42(10):4735–4743.Google Scholar
23. Lunn, DJ, Thomas, A, Best, N, Spiegelhalter, D. WinBUGS: a Bayesian modelling framework: concepts, structure, and extensibility. Stat Comput 2000;10:325–337.Google Scholar
24. Lawson, A, Browne, WJ, Vidal Rodeiro, CL. Disease mapping with WinBUGS and MLwiN. In: Statistics in Practice. Chichester, UK: Wiley, 2003.Google Scholar
25. Besag, J, York, J, Mollié, A. Bayesian image restoration, with two applications in spatial statistics. Ann Inst Stat Math 1991;43(1): 1–20.Google Scholar
26. Anselin, L, Syabri, I, Kho, Y. GeoDa: an introduction to spatial data analysis. Geograph Anal 2006;38(1):5–22.Google Scholar
27. Ventrucci, M. Multiple Testing in Spatial Epidemiology: a Bayesian Approach [dissertation J. Bologna, Italy: University of Bologna, 2009.Google Scholar
28. Australian Bureau of Statistics (ABS). Australian Standard Geographical Classification (ASGC) Digital Boundaries (Intercensal). Canberra, Australia: ABS, 2010. http://www.abs.gov.au/AUSSTATS/[email protected]/DetailsPage/1259.0.30.001July%202010?OpenDocument.Google Scholar
29. Bastin, L, Rollason, J, Hilton, A, et al. Spatial aspects of MRSA epidemiology: a case study using stochastic simulation, kernel estimation and SaTScan. Int J Geograph Inform Sci 2007;21(7): 811–836.Google Scholar
30. Rossini, CJ, Moriarty, KP, Tashjian, DB, Garb, JL, Wait, RB. Geographic distribution of community-acquired methicillin-resistant Staphylococcus aureus soft tissue infections. J Pediatr Surg 2011;46(6):1089–1092.Google Scholar
31. David, MZ, Daum, RS. Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic. Clin Microbiol Rev 2010;23(3): 616–687.Google Scholar
32. Australian Institute of Health and Welfare. Aged Care, http://www.aihw.gov.au/aged-care-indigenous/#aged. Published 2012. Accessed September 24, 2012.Google Scholar
33. Commonwealth Government of Australia. Closing the Gap on Indigenous Disadvantage: The Challenge for Australia. Canberra, Australia: Commonwealth Government of Australia, 2009.Google Scholar
34. Department of Families, Housing, Community Services and Indigenous Affairs, Commonwealth of Australia. Closing the Gap. http://www.fahcsia.gov.au/sa/indigenous/progserv/ctg/Pages/default.aspx. Accessed February 18, 2012.Google Scholar
35. Australian Group on Antimicrobial Resistance. MRSA Typing and Epidemiology Reports, http://www.agargroup.org/surveys. Published 2012. Accessed August 23, 2012.Google Scholar
36. Australian Institute of Health and Welfare (AIHW). Improving the Quality of Indigenous Identification in Hospital Separations Data. Canberra, Australia: AIHW, 2005. Report no. HSW 101.Google Scholar