High Burden of Staphylococcus aureus Among Native American Individuals on the White Mountain Apache Tribal Lands

Catherine G Sutcliffe; Lindsay R Grant; Angelina Reid; Grace Douglass; Laura B Brown; Kamellia Kellywood; Robert C Weatherholtz; Robin Hubler; Alvaro Quintana; Ryan Close; James B McAuley; Mathuram Santosham; Katherine L O'Brien; Laura L Hammitt

doi:10.1093/ofid/ofaa061

High Burden of Staphylococcus aureus Among Native American Individuals on the White Mountain Apache Tribal Lands

Open Forum Infect Dis. 2020 Feb 22;7(3):ofaa061. doi: 10.1093/ofid/ofaa061. eCollection 2020 Mar.

Authors

Affiliations

¹ Center for American Indian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
² Pfizer Vaccine Medical Development, Scientific and Clinical Affairs, Collegeville, Pennsylvania, USA.
³ Whiteriver Service Unit, Indian Health Service, Whiteriver, Arizona, USA.
⁴ Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁵ Rush Medical College, Rush University, Chicago, Illinois, USA.

Abstract

Background: This study was done to determine the burden of invasive Staphylococcus aureus on the White Mountain Apache Tribal lands.

Methods: Active population and laboratory-based surveillance for invasive S aureus infections was conducted from May 2016 to April 2018. A case was defined as a Native American individual living on or around the White Mountain Apache Tribal lands with S aureus isolated from a normally sterile body site.

Results: Fifty-three cases were identified. Most cases were adults (90.6%) and had ≥1 underlying medical condition (86.8%), the most common of which were diabetes (49.1%) and obesity (41.5%). A total of 26.4% cases were categorized as community acquired. Most infections were methicillin-resistant (75.5%). A total of 7.5% of cases required amputation, and 7.7% of cases died within 30 days of initial culture. The incidence of invasive S aureus was 156.3 per 100 000 persons. The age-adjusted incidence of invasive methicillin-resistant S aureus was 138.2 per 100 000 persons.

Conclusions: This community has a disproportionately high burden of invasive methicillin-resistant S aureus compared with the general US population. Interventions are urgently needed to reduce the morbidity and mortality associated with these infections.

Keywords: MRSA; Native Americans; invasive bacterial infections; surveillance.