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

PLoS One. 2013;8(4):e60872. doi: 10.1371/journal.pone.0060872. Epub 2013 Apr 2.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Arizona / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Male
  • Methicillin-Resistant Staphylococcus aureus / pathogenicity*
  • Seasons
  • Skin Diseases, Infectious / epidemiology*
  • Skin Diseases, Infectious / microbiology
  • Soft Tissue Infections / epidemiology*
  • Soft Tissue Infections / microbiology
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Skin Infections / epidemiology
  • Young Adult

Grants and funding

This work was supported by the Arizona Biomedical Research Commission (http://azdhs.gov/biomedical/) with Commission Contract No.1216. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.