The burden of Staphylococcus aureus among Native Americans on the Navajo Nation

PLoS One. 2019 Mar 5;14(3):e0213207. doi: 10.1371/journal.pone.0213207. eCollection 2019.

Abstract

Introduction: Native Americans in the southwestern United States have a higher risk for many infectious diseases and may be at higher risk for Staphylococcus aureus due to the high prevalence of risk factors for S. aureus. Recent data on invasive S. aureus infections among Native Americans are limited.

Methods: Active population- and laboratory-based surveillance was conducted in 2016-2017 on the Navajo Nation to document the rate of invasive S. aureus. A case of invasive S.aureus infection was defined as a Native American individual with S. aureus isolated from a normally sterile body site whose reported community of residence was on or around the Navajo Nation.

Results: One hundred and fifty-nine cases of invasive S. aureus from 152 individuals were identified. The median age of cases was 56.3 years and 35% were female. Thirty-five percent of cases had community-acquired infections. Ninety-three percent of cases had underlying medical conditions, including diabetes (60%) and obesity (42%), 28% of cases had a documented prior S. aureus infection, and 33% were infected with methicillin-resistant S. aureus. The annual incidence of invasive S. aureus and of invasive methicillin-resistant S. aureus was 64.9/100,000 persons and 21.2/100,000 persons, respectively.

Conclusions: This community has a high burden of invasive S. aureus infections. Further research is needed to identify prevention strategies and opportunities for intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Community-Acquired Infections / epidemiology*
  • Community-Acquired Infections / microbiology
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Female
  • Humans
  • Incidence
  • Indians, North American / statistics & numerical data*
  • Infant
  • Male
  • Middle Aged
  • Population Surveillance
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Staphylococcus aureus / isolation & purification
  • Staphylococcus aureus / pathogenicity*
  • United States / epidemiology
  • Young Adult

Grants and funding

This work was supported through a Clinical Research Collaboration award from Pfizer Inc. to LLH (protocol number: 1605050000 to LLH). Authors RH and AQ, who contributed to the design of the study and review of the manuscript, are employees of Pfizer. The funder did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section. Disclaimer: The opinions expressed are those of the authors and do not necessarily reflect the views of Pfizer Inc.