Evidence map›Paper›PMID 40114093›Full record

SynthesisBMC public health2025

Neighborhood-level income and MRSA infection risk in the USA: systematic review and meta-analysis.

Sarah Blackmon, Esther E Avendano, Sweta Balaji, Samson Alemu Argaw, Rebecca A Morin, Nanguneri Nirmala, Shira Doron, Maya L Nadimpalli

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sarah BlackmonDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Esther E AvendanoWCG Clinical, Princeton, NJ, USA.
Sweta BalajiDepartment of Quantitative Theory and Methods, Emory University, Atlanta, GA, USA.
Samson Alemu ArgawHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Rebecca A MorinHirsh Health Sciences Library, Tufts University, Boston, MA, USA.
Nanguneri NirmalaInstitute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
Shira DoronDivision of Geographic Medicine and Infectious Disease, Department of Medicine, Tufts Medical Center, Boston, MA, USA.
Maya L NadimpalliStuart B. Levy Center for Integrated Management of Antimicrobial Resistance (Levy CIMAR), Tufts University, Boston, MA, USA. maya.l.nadimpalli@emory.edu.

Funding

Antibacterial Resistance Leadership Group (ARLG)UM1AI104681 · NIAID · DUKE UNIVERSITY · PI Vance G. Fowler, Henry F HENRY CHAMBERS · 2013 to 2026
$180.8M
National Institute of Allergy and Infectious Diseases UM1AI104681NIAID NIH HHS UM1 AI104681
6 · The paper itself

Abstract

backgroundThe impact of neighborhood-level income on community-associated methicillin-resistant S. aureus (CA-MRSA) risk remains poorly understood, despite established associations between MRSA risk and the social determinants of health. There are conflicting findings in the existing literature and no known systematic reviews based in the U.S. Our objective was to conduct a systematic review and meta-analysis of the association between neighborhood-level income and CA-MRSA in the U.S.

methodsWe searched MEDLINE (Ovid), MEDLINE Epub Ahead of Print, In-Process, In-Data-Review & Other Non-Indexed Citations, and Daily (Ovid), Global Health (Ovid), Embase (Elsevier), Cochrane Database of Systematic Reviews (Wiley), Cochrane Central Register of Controlled Trials (Wiley), and Web of Science Core Collection from 2017 to 10 January 2021. An updated search was completed in November 2023. Eligible studies reported stratified CA-MRSA case counts and/or effect measures by neighborhood income level, reported as a categorical or continuous variable. Relevant data were extracted using Covidence following the PRISMA guidelines. A random-effects model meta-analysis was used to estimate the pooled effect measure. Three study design-specific risk of bias assessments and a quality assessment were applied using the modified Newcastle-Ottawa Quality Assessment Scale and GRADE approach, respectively.

resultsSix publications met eligibility criteria. Five found that living in a low-income neighborhood was associated with increased CA-MRSA risk. Among the four studies eligible for the meta-analysis, the pooled odds ratio for CA-MRSA infection among low vs. high-income neighborhoods (reference group) was 1.28 (95% CI: 1.13, 1.46), with statistical heterogeneity (I

conclusionsEvidence supports an association between lower neighborhood income and higher CA-MRSA infection risk, albeit with considerable heterogeneity. Future studies should consider evaluating neighborhood-level income as a continuous variable, and at the block-group level to avoid exposure misclassification. Furthermore, researchers should consider adjusting for covariates that could allow for a causal interpretation of the relationship between low neighborhood-level income and CA-MRSA risk.

Indexed as

IncomeMethicillin-Resistant Staphylococcus aureusNeighborhood CharacteristicsStaphylococcal InfectionsCommunity-Acquired InfectionsHumansRisk FactorsUnited StatesIncomeMRSASocial determinants of healthSystematic review

Identifiers

PMID40114093
PMCPMC11927133

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.