Is neighborhood deprivation index a risk factor for Staphylococcus aureus infections?

• Published in: American journal of infection control 2023-12, Vol.51 (12), p.1314-1320
• Main Authors: Sood, Geeta, Dougherty, Geoff, Martin, John, Beranek, Edward, Landrum, B. Mark, Qasba, Sonia, Patel, Mayank, Wilson, Christina, Miller, Amanda, Sulkowski, Mark, Bennett, Richard G., Sears, Cynthia L., Schuster, Alyson, Galai, Noya
• Format: Article
• Language: English
• Subjects: ADI; Area deprivation index; Social determinants of health
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2023.07.001

We assessed the association between neighborhood area deprivation index (ADI) and community-onset (co) and hospital-onset (ho) Staphylococcus aureus infection. Demographic and clinical characteristics of patients admitted to 5 adult hospitals in the mid-Atlantic between 2016 and 2018 were obtained. The association of ADI with methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) S aureus infections was assessed using logistic regression models adjusting for severity of illness and days of admission. Overall, increasing ADI was associated with higher odds of co- and ho-MRSA and MSSA infection. In univariate analysis, Black race was associated with 44% greater odds of ho-MRSA infection (odds ratio [OR] 1.44; 95% CI 1.18-1.76) and Asian race (co-MRSA OR 0.355; Confidence Interval (CI) 0.240-0.525; co-MSSA OR 0.718; CI 0.557-0.928) and unknown race (co-MRSA OR 0.470; CI 0.365-0.606; co-MSSA OR 0.699; CI 0.577-0.848) was associated with lower odds of co-MSSA and co-MRSA infections. When both race and ADI were included in the model, Black race was no longer associated with ho-MRSA infections whereas Asian and unknown race remained associated with lower odds of co-MRSA and co-MSSA infection. In the multivariable logistic regression, ADI was consistently associated with increased odds of S aureus infection (co-MRSA OR 1.132; CI 1.064-1.205; co-MSSA OR 1.089; CI 1.030-1.15; ho-MRSA OR 1.29; CI 1.16-1.43: ho-MSSA OR 1.215; CI 1.096-1.346). The area deprivation index is associated with community and hospital-onset MRSA and MSSA infections. •Neighborhood area deprivation index correlates with community-onset and hospital-onset MRSA infection after adjusting for age and comorbid conditions using the Premier CareScience Mortality Risk Score.•Black race was association with hospital-onset MRSA infection in univariate analysis and was no longer associated with ho-MRSA infection when ADI was included in the model.•Asian race and unknown race was associated with lower odds of community-onset MRSA and MSSA infection.