A Spatial Analysis of Health Disparities Associated with Antibiotic Resistant Infections in Children Living in Atlanta (2002–2010)

Fatima Ali, L. Immergluck, T. Leong, L. Waller, K. Malhotra, R. Jerris, M. Edelson, G. Rust
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引用次数: 9

Abstract

Background: Antibiotic resistant bacteria like community-onset methicillin resistant Staphylococcus aureus (CO-MRSA) have continued to cause infections in children at alarming rates and are associated with health disparities. Geospatial analyses of individual and area level data can enhance disease surveillance and identify socio-demographic and geographic indicators to explain CO-MRSA disease transmission patterns and risks. Methods: A case control epidemiology approach was undertaken to compare children with CO-MRSA to a noninfectious condition (unintentional traumatic brain injury (uTBI)). In order to better understand the impact of place based risks in developing these types of infections, data from electronic health records (EHR) were obtained from CO-MRSA cases and compared to EHR data from controls (uTBI). US Census data was used to determine area level data. Multi-level statistical models were performed using risk factors determined a priori and geospatial analyses were conducted and mapped. Results: From 2002–2010, 4,613 with CO-MRSA and 34,758 with uTBI were seen from two pediatric hospitals in Atlanta, Georgia. Hispanic children had reduced odds of infection; females and public health insurance were more likely to have CO-MRSA. Spatial analyses indicate significant ‘hot spots’ for CO-MRSA and the overall spatial cluster locations, differed between CO-MRSA cases and uTBI controls. Conclusions: Differences exist in race, age, and type of health insurance between CO-MRSA cases compared to noninfectious control group. Geographic clustering of cases is distinct from controls, suggesting placed based factors impact risk for CO-MRSA infection.
亚特兰大儿童抗生素耐药性感染相关健康差异的空间分析(2002-2010)
背景:抗生素耐药性细菌,如社区发病的耐甲氧西林金黄色葡萄球菌(CO-MRSA),继续以惊人的速度导致儿童感染,并与健康差异有关。对个人和地区层面数据的地理空间分析可以加强疾病监测,并确定社会人口和地理指标,以解释耐甲氧西林金黄色葡萄球菌疾病传播模式和风险。方法:采用病例对照流行病学方法,将CO-MRSA儿童与非感染性疾病(非故意创伤性脑损伤(uTBI))进行比较。为了更好地了解基于地点的风险对这些类型感染的影响,从CO-MRSA病例中获得了电子健康记录(EHR)的数据,并与对照组(uTBI)的EHR数据进行了比较。美国人口普查数据用于确定地区层面的数据。使用事先确定的风险因素进行了多级统计模型,并进行了地理空间分析和绘制了地图。结果:从2002年到2010年,佐治亚州亚特兰大的两家儿科医院共发现4613例CO-MRSA患者和34758例uTBI患者。西班牙裔儿童感染的几率降低;女性和公共医疗保险更有可能患有耐甲氧西林金黄色葡萄球菌。空间分析表明,CO-MRSA的显著“热点”和总体空间聚类位置在CO-MRSA病例和uTBI对照组之间有所不同。结论:与非感染对照组相比,CO-MRSA病例在种族、年龄和医疗保险类型方面存在差异。病例的地理聚类与对照组不同,这表明基于位置的因素影响CO-MRSA感染的风险。
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