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.

Postoperative infection in spine surgery: does the month matter?

“…Specifically, investigators have found a statistically significant correlation between both temperature and humidity and S. aureus skin and soft-tissue infections. 36 McBride et al found that S. aureus bacterial populations on the skin are significantly higher during warm and humid months. 28 Skin-to-skin contact, which plays a large role in the nosocomial transmission of S. aureus , increases in frequency during the late summer.…”

“…Similarly, a recent time series analysis of 51,287 pediatric skin and soft-tissue infection clinical encounters found that rates of S. aureus infection were highest in the summer months. 36 …”

“…For example, infections caused by gram-negative bacteria such as Escherichia coli, Acinetobacter baumanii, Pseudomonas aureginosa , and Enterobacter cloacae occur more frequently in warmer summer and fall months than the remainder of the year. 13,24,29,31,33 Similarly, skin and soft-tissue infections caused by Staphylococcus aureus occur more frequently in the summer, 9,24,36 while pneumonia due to methicillin-resistant S. aureus (MRSA) may occur more frequently in the winter. 16,19,35 …”

Molecular Interactions of Human Plasminogen with Fibronectin-binding Protein B (FnBPB), a Fibrinogen/Fibronectin-binding Protein from Staphylococcus aureus

“…For example, degradation of host-or SAK-promoted fibrin clots could help bacteria to spread (37). Damage to subcutaneous tissue could contribute to the pathogenesis of skin soft tissue infections caused by CA-MRSA (38). Degradation of opsonins could contribute to the avoidance of neutrophil-mediated phagocytosis and killing (20 -22).…”

Seasonal Variation of Common Surgical Site Infections: Does Season Matter?

“…Similarly, a recent time series analysis of 51,287 pediatric skin and soft-tissue infection clinical encounters found that rates of S. aureus infection were highest in the summer months. 22 In addition, Mermel et al 23 determined that seasonal variation of S. aureus , specifically community-acquired methicillin-resistant S. aureus , occurred in both adult and pediatric populations. Peritonitis infections involving coagulase-negative Staphylococcus also appear to be more common during the spring and summer.…”