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

• Type of Material: Article
• Authors: Fatima Ali, Louisville Metro Department of Public Health and Wellness; Lilly C. Immergluck, Morehouse School of Medicine; Traci Leong, Emory University; Lance Waller, Emory University; Khusdeep Malhotra, Temple University; Robert Charles Jerris, Emory University; Mike Edelson, InterDev; George S. Rust, Florida State University
• Language: English
• Date: 2019-09-12
• Publisher: Ubiquity Press
• Publication Version: Final Published Version
• Copyright Statement: Copyright : © 2019 The Author(s)
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.5334/egems.308
• Title of Journal or Parent Work: eGEMs (Wash DC)
• ISSN: 2327-9214
• Volume: 7
• Issue: 1
• Start Page: 50
• End Page: 50
• Grant/Funding Information: Research reported in this publication was supported in part by funds received from K-08 AHRQ-Mentored Clinical Scientist Career Research Development Award–HS024338-01; the Georgia Institute of Technology’s Health System’s Institute; PHS Grant UL1 RR025008 from the Clinical and Translational Science Award program, National Institute of Health, as part of the Georgia’s Clinical & Translational Science Institute; Grant Number 2R25RR017694-06A1; and Grant Number G12-RR03034, a component of the National Institute of Health.
• Keywords: spatial analyses; antibiotic resistant bacteria; community-associated MRSA; pediatrics
• Research Categories: Health Sciences, Pathology; Health Sciences, Public Health; Biology, Biostatistics

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.