title: Epidemics of community-associated methicillin-resistant Staphylococcus aureus in the United States: a meta-analysis.
abstract: Staphylococcus aureus is the most frequent cause of skin and soft tissue infections in humans. Methicillin-resistant strains of S. aureus (MRSA) that emerged in the 1960s presented a relatively limited public health threat until the 1990s, when novel community-associated (CA-) MRSA strains began circulating. CA-MRSA infections are now common, resulting in serious and sometimes fatal infections in otherwise healthy people. Although some have suggested that there is an epidemic of CA-MRSA in the U.S., the origins, extent, and geographic variability of CA-MRSA infections are not known. We present a meta-analysis of published studies that included trend data from a single site or region, and derive summary epidemic curves of CA-MRSA spread over time. Our analysis reveals a dramatic increase in infections over the past two decades, with CA-MRSA strains now endemic at unprecedented levels in many US regions. This increase has not been geographically homogeneous, and appears to have occurred earlier in children than adults.
authors.affiliation: Department of Applied Mathematics, University of Colorado, Boulder, Colorado, United States of America.
authors.forename: Vanja M
authors.initials: VM
authors.lastname: Dukic
authors.forename: Diane S
authors.initials: DS
authors.lastname: Lauderdale
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Wilder
authors.forename: Robert S
authors.initials: RS
authors.lastname: Daum
authors.forename: Michael Z
authors.initials: MZ
authors.lastname: David
mesh_terms: D000465:Algorithms; D003140:Communicable Disease Control; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D005843:Geography; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015233:Models, Statistical; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology; D013997:Time Factors; D014481:United States