A population based study of seasonality of skin and soft tissue infections: implications for the spread of CA-MRSA

• Published in: PloS one 2013-04, Vol.8 (4), p.e60872-e60872
• Main Authors: Wang, Xiaoxia, Towers, Sherry, Panchanathan, Sarada, Chowell, Gerardo
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Arizona - epidemiology; Bacterial infections; Biology; Child; Child, Preschool; Children; Climate change; Correlation; Data processing; Drug resistance; Emergency medical care; Epidemiology; Female; Government programs; Health care; Humans; Humidity; Incidence; Infant; Infant, Newborn; Infections; Infectious skin diseases; Influence; Laboratories; Male; Mathematics; Mean temperatures; Medicine; Methicillin; Methicillin-Resistant Staphylococcus aureus - pathogenicity; Nonlinear analysis; Pediatrics; Periodic variations; Periodicity; Physiological aspects; Population; Population studies; Population-based studies; Public health; Regression analysis; Risk factors; Seasonal variations; Seasons; Skin; Skin Diseases, Infectious - epidemiology; Skin Diseases, Infectious - microbiology; Social change; Soft Tissue Infections - epidemiology; Soft Tissue Infections - microbiology; Specific humidity; Staphylococcal Infections - epidemiology; Staphylococcal Skin Infections - epidemiology; Staphylococcus aureus; Staphylococcus infections; Studies; Temperature; Temporal variations; Time series; Trends; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0060872

Methicillin resistant Staphylococcus aureus (MRSA) is currently a major cause of skin and soft tissue infections (SSTI) in the United States. Seasonal variation of MRSA infections in hospital settings has been widely observed. However, systematic time-series analysis of incidence data is desirable to understand the seasonality of community acquired (CA)-MRSA infections at the population level. In this paper, using data on monthly SSTI incidence in children aged 0-19 years and enrolled in Medicaid in Maricopa County, Arizona, from January 2005 to December 2008, we carried out time-series and nonlinear regression analysis to determine the periodicity, trend, and peak timing in SSTI incidence in children at different age: 0-4 years, 5-9 years, 10-14 years, and 15-19 years. We also assessed the temporal correlation between SSTI incidence and meteorological variables including average temperature and humidity. Our analysis revealed a strong annual seasonal pattern of SSTI incidence with peak occurring in early September. This pattern was consistent across age groups. Moreover, SSTIs followed a significantly increasing trend over the 4-year study period with annual incidence increasing from 3.36% to 5.55% in our pediatric population of approximately 290,000. We also found a significant correlation between the temporal variation in SSTI incidence and mean temperature and specific humidity. Our findings could have potential implications on prevention and control efforts against CA-MRSA.