title: Climatic factors and community - associated methicillin-resistant Staphylococcus aureus skin and soft-tissue infections - a time-series analysis study.
abstract: Skin and soft tissue infections caused by Staphylococcus aureus (SA-SSTIs) including methicillin-resistant Staphylococcus aureus (MRSA) have experienced a significant surge all over the world. Changing climatic factors are affecting the global burden of dermatological infections and there is a lack of information on the association between climatic factors and MRSA infections. Therefore, association of temperature and relative humidity (RH) with occurrence of SA-SSTIs (n = 387) and also MRSA (n = 251) was monitored for 18 months in the outpatient clinic at a tertiary care hospital located in Bhubaneswar, Odisha, India. The Kirby-Bauer disk diffusion method was used for antibiotic susceptibility testing. Time-series analysis was used to investigate the potential association of climatic factors (weekly averages of maximum temperature, minimum temperature and RH) with weekly incidence of SA-SSTIs and MRSA infections. The analysis showed that a combination of weekly average maximum temperature above 33 °C coinciding with weekly average RH ranging between 55% and 78%, is most favorable for the occurrence of SA-SSTIs and MRSA and within these parameters, each unit increase in occurrence of MRSA was associated with increase in weekly average maximum temperature of 1.7 °C (p = 0.044) and weekly average RH increase of 10% (p = 0.097).
authors.affiliation: Department of Public Health Sciences (Global health/IHCAR), Karolinska Institutet, Stockholm 17177, Sweden. sahookrushna@yahoo.com.
authors.forename: Krushna Chandra
authors.initials: KC
authors.lastname: Sahoo
authors.affiliation: Department of Microbiology, Kalinga Institute of Medical Sciences (KIMS), Super Religare Laboratories Limited, Kalinga Hospital, Bhubaneswar 751024, India. sk.soumya@gmail.com.
authors.forename: Soumyakanta
authors.initials: S
authors.lastname: Sahoo
authors.affiliation: Department of Public Health Sciences (Global health/IHCAR), Karolinska Institutet, Stockholm 17177, Sweden. gaetano.marrone@ki.se.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Marrone
authors.affiliation: Department of Public Health Sciences (Global health/IHCAR), Karolinska Institutet, Stockholm 17177, Sweden. ashish.pathak@ki.se.
authors.forename: Ashish
authors.initials: A
authors.lastname: Pathak
authors.affiliation: Department of Public Health Sciences (Global health/IHCAR), Karolinska Institutet, Stockholm 17177, Sweden. Cecilia.Stalsby.Lundborg@ki.se.
authors.forename: Cecilia Stålsby
authors.initials: CS
authors.lastname: Lundborg
authors.affiliation: Department of Public Health Sciences (Global health/IHCAR), Karolinska Institutet, Stockholm 17177, Sweden. ejetee@gmail.com.
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Tamhankar
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002980:Climate; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008712:Methicillin / Q000494:pharmacology*; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D012307:Risk Factors; D012621:Seasons; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000453:epidemiology / Q000382:microbiology; D063128:Tertiary Health Care
chemical_list: D000900:Anti-Bacterial Agents; D008712:Methicillin