ArticleBMC infectious diseases2019
Geographic surveillance of community associated MRSA infections in children using electronic health record data.
Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 25 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- The intersection of the social determinants of health and antimicrobial resistance in human populations: a systematic review.BMJ global health · 2025Pooled it
- Neighborhood-level income and MRSA infection risk in the USA: systematic review and meta-analysis.BMC public health · 2025Pooled it
- Application of Spatial Analysis on Electronic Health Records to Characterize Patient Phenotypes: Systematic Review.JMIR medical informatics · 2024Pooled it
- Pooled it
- Ethical Aspects of Personalized Research and Management of Systemic Inflammatory Response Syndrome (SIRS) in Children.International journal of environmental research and public health · 2022Pooled it
- Spatiotemporal trends in tetracycline- and trimethoprim-sulfamethoxazole-resistantEpidemiology and infection · 2026Article
- Association of factors linked to health inequalities and the risk of antibiotic-resistant infection in high-income countries: a systematic scoping review.JAC-antimicrobial resistance · 2025Review
- Race, ethnicity and risk for colonisation and infection with key bacterial pathogens: a scoping review.BMJ global health · 2025Article
- Socioeconomic status and the risk for colonisation or infection with priority bacterial pathogens: a global evidence map.The Lancet. Microbe · 2025Review
- Variation in facility-level likelihood of drug-resistantAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Associations between neighbourhood-level median household income and outpatients' risk of antibiotic non-susceptible uropathogens in a major urban centre, USA.JAC-antimicrobial resistance · 2024Article
- OralPathogens (Basel, Switzerland) · 2024Article
- Antimicrobial Resistance Patterns of Outpatient Staphylococcus aureus Isolates.JAMA network open · 2024Article
- Socioeconomic status and the risk for colonization or infection with priority bacterial pathogens: a global evidence map.medRxiv : the preprint server for health sciences · 2024Article
- Community-acquired Staphylococcus aureus skin and soft tissue infection risk assessment using hotspot analysis and risk maps: the case of California emergency departments.BMC public health · 2024Article
- Risk Factors Associated with Pyogenic Spinal Infections among Intravenous Drug Users and Nonusers.Advances in orthopedics · 2024Article
- New Dual Inhibitors of Bacterial Topoisomerases with Broad-Spectrum Antibacterial Activity and In Vivo Efficacy against Vancomycin-IntermediateJournal of medicinal chemistry · 2023Article
- How Antimicrobial Resistance Is Linked to Climate Change: An Overview of Two Intertwined Global Challenges.International journal of environmental research and public health · 2023Review
- Machine learning to predict risk for community-onset Staphylococcus aureus infections in children living in southeastern United States.PloS one · 2023Article
- Association between antibiotic resistance and increasing ambient temperature in China: An ecological study with nationwide panel data.The Lancet regional health. Western Pacific · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundCommunity- associated methicillin resistant Staphylococcus aureus (CA-MRSA) cause serious infections and rates continue to rise worldwide. Use of geocoded electronic health record (EHR) data to prevent spread of disease is limited in health service research. We demonstrate how geocoded EHR and spatial analyses can be used to identify risks for CA-MRSA in children, which are tied to place-based determinants and would not be uncovered using traditional EHR data analyses.
methodsAn epidemiology study was conducted on children from January 1, 2002 through December 31, 2010 who were treated for Staphylococcus aureus infections. A generalized estimated equations (GEE) model was developed and crude and adjusted odds ratios were based on S. aureus risks. We measured the risk of S. aureus as standardized incidence ratios (SIR) calculated within aggregated US 2010 Census tracts called spatially adaptive filters, and then created maps that differentiate the geographic patterns of antibiotic resistant and non-resistant forms of S. aureus.
resultsCA-MRSA rates increased at higher rates compared to non-resistant forms, p = 0.01. Children with no or public health insurance had higher odds of CA-MRSA infection. Black children were almost 1.5 times as likely as white children to have CA-MRSA infections (aOR 95% CI 1.44,1.75, p < 0.0001); this finding persisted at the block group level (p < 0.001) along with household crowding (p < 0.001). The youngest category of age (< 4 years) also had increased risk for CA-MRSA (aOR 1.65, 95%CI 1.48, 1.83, p < 0.0001). CA-MRSA encompasses larger areas with higher SIRs compared to non-resistant forms and were found in block groups with higher proportion of blacks (r = 0.517, p < 0.001), younger age (r = 0.137, p < 0.001), and crowding (r = 0.320, p < 0.001).
conclusionsIn the Atlanta MSA, the risk for CA-MRSA is associated with neighborhood-level measures of racial composition, household crowding, and age of children. Neighborhoods which have higher proportion of blacks, household crowding, and children < 4 years of age are at greatest risk. Understanding spatial relationship at a community level and how it relates to risks for antibiotic resistant infections is important to combat the growing numbers and spread of such infections like CA-MRSA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.