142nd APHA Annual Meeting and Exposition

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Staphylococcus Aureus Nasal Colonization in the United States: Analysis of Risk and Protective Factors from the National Health and Nutrition Examination Survey, 2001-2004

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:00 PM - 3:15 PM

Antonio Bustillo, BS , Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
Stacey L. Tannenbaum, PhD, RD, LD/N , Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
Tulay Koru-Sengul, MHS, PhD , Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
Background: Staphylococcus-aureus (SA) and Methicillin-resistant-SA (MRSA) are increasingly found outside of hospitals and in community settings. We examined risk and protective factors of nasal-colonization with SA and MRSA in a population-based dataset.

Methods: We used data from 2001-2004 National Health and Nutritional Examination Survey, a representative survey of US non-institutionalized civilian population, to determine prevalence, and risk, and protective factors for nasal-colonization with SA and MRSA. We utilized information on nasal-colonization status with SA, MRSA, Staphylococcal cassette chromosome (SCCmec) type/subtypes, and socio-demographics (age, gender, race/ethnicity, marital status, smoking status, secondhand-smoke-exposure (SHS), poverty-index). We calculated odds-ratios (OR) with 95% confidence intervals (95%CI) from multivariate logistic regression models, accounting for the complex sampling design.

Results: SA nasal-colonization prevalence decreased from 32.4% (2001-2002) to 28.6% (2003-2004). Being divorced/separated/widowed (OR=1.32; 95%CI=1.1-1.59) was a risk factor; increased age (OR=0.99; 95%CI=0.98-0.99), females (OR=0.65; 95%CI=0.55-0.75), non-Hispanic-Blacks (OR=0.62; 95%CI=0.52-0.74) and current-smokers (OR=0.71; 95%CI=0.62-0.80) were protected from SA colonization. MRSA nasal-colonization prevalence increased from 2.6% (2001-2002) to 5.2% (2003-2004). The majority of MRSA isolates had Type-II-SCCmec (51%) while 49% had Type-IV-SCCmec. Significant risk factors for MRSA nasal-colonization included increasing age (OR=1.03; 95%CI=1.01-1.06), being female (OR=2.37; 95%CI=1.41-3.98), and former smokers (OR=3.12; 95%CI=1.44-6.79).

Discussion: SA nasal-colonization shows a reversed pattern of risk and protective factors from that of MRSA. Prevalence of MRSA has increased while SA nasal-colonization has decreased. Moreover, increased prevalence of type-II-SCCmec in community-based settings may reflect an alarming propagation trend of this primarily hospital-acquired infection. Future research should investigate methods to contain this potentially devastating public health burden.

Learning Areas:

Basic medical science applied in public health
Occupational health and safety
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research

Learning Objectives:
Identify the risk and protective factors for Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus nasal colonization. Compare the risk and protective factors for Staphylococcus aureus and Methicillin-Resistant Staphylococcus aureus nasal colonization.

Keyword(s): Epidemiology, Pathogens

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am public health graduate student who has been doing research on this topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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