Geocoding and Linking Data from Population-based Surveillance and the US Census to Evaluate the Impact of Median Household Income on the Epidemiology of Invasive Streptococcus pneumoniae Infections

作者：Fei Chen, Robert F. Breiman, Morgan Jane Farley, Brian D. Plikaytis, K.A. Deaver, Martín S. Cetron · 发表于：American Journal of Epidemiology · 年份：1998 · DOI：10.1093/oxfordjournals.aje.a009611 · 被引用次数：89 · 研究领域：Pneumonia and Respiratory Infections、Respiratory viral infections research、Bacterial Infections and Vaccines

The emergence of drug-resistant Streptococcus pneumoniae poses new clinical challenges and may also reflect a change in the epidemiology of S. pneumoniae infections. A variety of studies have shown that drug-resistant S. pneumoniae infections are linked to antimicrobial use. It has been hypothesized that persons of high socioeconomic status are at increased risk for a drug-resistant infection because of greater access to antimicrobial drugs. To assess whether median household income is associated with increased risk of penicillin-nonsusceptible S. pneumoniae infections, the authors geocoded and linked data from population-based surveillance for invasive pneumococcal disease with data from the 1990 US Census. Among invasive pneumococcal isolates from Atlanta, Georgia, in 1994, increasing proportions of penicillin-nonsusceptible isolates were associated with higher median household incomes (chi2 for trend, 15.17; p=0.002). Despite higher rates of invasive pneumococcal disease among blacks and persons who resided within lower median household income areas, white patients in areas with higher median household income had a higher risk of being infected with strains that were not susceptible to penicillin (Wilcoxon rank sum, Z=2.66, p=0.008). These findings demonstrated the utility of geocoding and US Census data in describing the epidemiology of drug-resistant S. pneumoniae and also provided more evidence that socioeconomic factors may influence the development of drug resistance.