title: A population based study of seasonality of skin and soft tissue infections: implications for the spread of CA-MRSA.
abstract: 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.
authors.affiliation: Mathematical, Computational and Modeling Sciences Center, School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA. xwang248@asu.edu
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Wang
authors.forename: Sherry
authors.initials: S
authors.lastname: Towers
authors.forename: Sarada
authors.initials: S
authors.lastname: Panchanathan
authors.forename: Gerardo
authors.initials: G
authors.lastname: Chowell
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D001130:Arizona / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000472:pathogenicity*; D012621:Seasons; D012874:Skin Diseases, Infectious / Q000453:epidemiology* / Q000382:microbiology; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology; D055815:Young Adult
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