Evaluating Disparities in Invasive Staphylococcus aureus Incidence in 5 Counties in Metropolitan Atlanta, Georgia During the COVID-19 Pandemic 2020-2021 Público

Abstract

Invasive Staphylococcus aureus (iSA) has been shown to pose a disproportionate burden on Black and African American populations. Similarly, the COVID-19 pandemic has highlighted racial and ethnic disparities in healthcare access and outcomes. The purpose of this analysis was to measure the magnitude of change in incidence of iSA infections during the COVID-19 pandemic and to assess the impact of the COVID-19 pandemic on racial disparities in iSA incidence in five counties in the metro-Atlanta area from March 2020 to December 2021. Monthly, county-specific iSA and COVID-19 incidence rates were analyzed by race, susceptibility (MRSA or MSSA), and epi-onset category (hospital onset or community onset) to determine their effect on incidence of iSA. County-specific iSA rates were correlated with corresponding COVID-19 rates using Spearman's rank correlation, Kruskal-Wallis tests, and Poisson regression models. Increases in county-level COVID-19 incidence most strongly increased hospital onset iSA rates, as well as all iSA rates among non-Hispanic Black populations; although all categories of iSA increased with increasing COVID-19 rates, but to lessor degrees. There are a variety of systematic inequities and socioeconomic determinants that contribute to disproportionate disease impact that must be further researched to better understand the impact of the COVID-19 pandemic on disparities in outcomes related to healthcare-associated infections.

Table of Contents

Introduction and Background 1

Methods 4

iSA Case Definitions 5

COVID-19 Case Definitions 6

Statistical Analyses 7

Results 8

Discussion 11

Public Health Implications 14

Tables and Figures 15

References 23

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	COVID-19 healthcare-associated infections invasive Staphylococcus aureus
Committee Chair / Thesis Advisor	Scott Fridkin, Emory University

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