Background: USA300 MRSA is endemic in the community, with congregate settings such as urban jails potentially facilitating spread. It has been reported previously that males have a higher risk for MRSA carriage and bacteremia than females. However, it is unclear if there is differential risk for MRSA based on gender in high-risk populations. We determined the prevalence of MRSA colonization at jail entrance in females and defined an acquisition rate during incarceration.
Methods: Females incarcerated at the Cook County Jail, one of the largest US single-site jails, were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, groin) were collected to determine prevalence of MRSA colonization. A survey was administered to identify predictors of colonization. Detainees in jail at Day30 had cultures repeated to determine MRSA acquisition. Univariate and multivariate analyses were performed to identify predictors of MRSA colonization.
Results: 250 women were enrolled (70% AA, 15% Hispanic) with 70% previously in jail (21% in the past 6 months). The prevalence of MRSA colonization at intake was 20% (50/250), with 42% of those colonized solely in the throat or groin. This intake prevalence is comparable to the 19% for male detainees in a parallel study. 9% (2/23) of initially negative women who remained in jail for 30 days acquired MRSA; 5 remained colonized and no one lost colonization. Univariate predictors (Table) of MRSA at entrance to the jail were: illicit drug use (including using needles), unstable housing, engaging in anal sex, and recent exchange of sex for drugs/money. Women who exchange sex for drugs/money (vs not) reported higher rates of needle use (35% v 4%, p<0.001) and unstable housing (80% v 20%, p<0.001). With multivariate adjustment for race/ethnicity, needles for illicit drugs was a significant predictor of MRSA (OR 5.89,95%CI,1.66,20.94,p=0.006).
Conclusion: We found that a high proportion (20%) of females entered jail colonized with MRSA, comparable to rates in males, suggesting that previously reported gender disparities in MRSA may not exist in high-risk populations. Entrance colonization risk factors suggest high-risk activities or venues in the community, with potential for directing gender-specific interventions.
K. J. Popovich,
A. Aroutcheva, None
D. Payne, None
M. Schoeny, None
L. Diep, None
B. Hota, None
M. K. Hayden, None
R. A. Weinstein, None
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