Biggs Holly M, Li Rongxia, Jackson Kelly A, Nadle Joelle, Petit Susan, Ray Susan M, Lynfield Ruth, Como-Sabetti Kathryn, Dumyati Ghinwa, Gellert Anita, Walsh Marissa, Schaffner William, Baggs James, See Isaac
Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
California Emerging Infections Program, Oakland, California, USA.
Open Forum Infect Dis. 2025 May 12;12(6):ofaf282. doi: 10.1093/ofid/ofaf282. eCollection 2025 Jun.
The impact of the coronavirus disease 2019 (COVID-19) pandemic on methicillin-resistant (MRSA) bacteremia incidence compared with prepandemic trends is unknown.
Active laboratory- and population-based surveillance identified incident MRSA blood isolates among surveillance area residents in 6 continuously reporting sites during 2005-2022. Annual incidence per 100 000 census population was stratified by epidemiologic classification (hospital-onset, community-associated, health care-associated community-onset). Joinpoint with Poisson regression was used to determine incidence trend segments and annual percent change (APC; 2005-2019) and predicted incidence (2020-2022). Recent COVID-19 was a positive severe acute respiratory syndrome coronavirus 2 viral test ≤30 days before incident MRSA culture.
Overall declines in MRSA bacteremia incidence during 2005-2016 (APC, -7.1; < .001) reversed during 2016-2019 (APC, +5.9; < .001). Hospital-onset incidence did not change significantly during 2014-2019 (APC, -1.5; = .32), but during 2020-2022 it was higher than during 2016-2019 and significantly higher than predicted in 2021. Health care-associated community-onset incidence increased during 2017-2019 (APC, +8.4; < .001); 2021 incidence was the lowest observed during 2005-2022, although it was not significantly lower than predicted. Community-associated incidence was increasing prepandemic (APC, +8.4; < .001), but during 2020-2022 it was lower than predicted. During 2020-2022, the proportion of cases with recent COVID-19 was highest among hospital-onset infections (18%-22%); 2021 hospital-onset incidence excluding these cases fell within the predicted range.
Previous declines in MRSA bacteremia incidence had ended before the COVID-19 pandemic. During 2020-2022, patients with recent COVID-19 contributed substantially to increases in hospital-onset MRSA bacteremia, suggesting a need for robust infection prevention in this population. Reversal of prepandemic increases in health care-associated community-onset and community-associated infections during the pandemic could be related to COVID-19 mitigation measures.
与疫情前的趋势相比，2019年冠状病毒病（COVID-19）大流行对耐甲氧西林金黄色葡萄球菌（MRSA）菌血症发病率的影响尚不清楚。
基于实验室和人群的主动监测确定了2005年至2022年期间6个持续报告地点的监测区域居民中MRSA血培养分离株。每10万人口的年发病率按流行病学分类（医院获得性、社区相关性、医疗保健相关社区获得性）进行分层。使用泊松回归的连接点来确定发病率趋势段和年度百分比变化（APC；2005 - 2019年）以及预测发病率（2020 - 2022年）。近期COVID-19定义为在MRSA感染事件发生前≤30天的严重急性呼吸综合征冠状病毒2病毒检测呈阳性。
2005年至2016年期间MRSA菌血症发病率总体下降（APC，-7.1；P <.001），在2016年至2019年期间逆转（APC，+5.9；P <.001）。医院获得性发病率在2014年至2019年期间没有显著变化（APC，-1.5；P =.32），但在2020年至2022年期间高于2016年至2019年期间，且在2021年显著高于预测值。医疗保健相关社区获得性发病率在2017年至2019年期间增加（APC，+8.4；P <.001）；2021年发病率是2005年至2022年期间观察到的最低值，尽管并不显著低于预测值。社区相关性发病率在疫情前呈上升趋势（APC，+8.4；P <.001），但在2020年至2022年期间低于预测值。在2020年至2022年期间，近期感染COVID-19的病例比例在医院获得性感染中最高（18% - 22%）；排除这些病例后，2021年医院获得性发病率在预测范围内。
在COVID-19大流行之前，MRSA菌血症发病率此前的下降趋势已经结束。在2020年至2022年期间，近期感染COVID-19的患者在医院获得性MRSA菌血症增加中占很大比例，这表明该人群需要强有力的感染预防措施。疫情期间医疗保健相关社区获得性和社区相关性感染在疫情前上升趋势的逆转可能与COVID-19缓解措施有关。
