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Community-acquired Staphylococcus aureus skin and soft tissue infection risk assessment using hotspot analysis and risk maps: the case of California emergency departments.
Morgan Bustamante, Brittany L; Fejerman, Laura; May, Larissa; Martínez-López, Beatriz.
Afiliación
  • Morgan Bustamante BL; Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA. blmb@berkeley.edu.
  • Fejerman L; Center for Animal Disease Modeling and Surveillance, Department of Veterinary Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA. blmb@berkeley.edu.
  • May L; Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA.
  • Martínez-López B; Emergency Medicine, School of Medicine, University of California, Davis, Davis, CA, USA.
BMC Public Health ; 24(1): 123, 2024 01 09.
Article en En | MEDLINE | ID: mdl-38195461
ABSTRACT

BACKGROUND:

Community-acquired Staphylococcus aureus (CA-Sa) skin and soft tissue infections (SSTIs) are historically associated with densely populated urban areas experiencing high poverty rates, intravenous drug use, and homelessness. However, the epidemiology of CA-Sa SSTIs in the United States has been poorly understood since the plateau of the Community-acquired Methicillin-resistant Staphylococcus aureus epidemic in 2010. This study examines the spatial variation of CA-Sa SSTIs in a large, geographically heterogeneous population and identifies neighborhood characteristics associated with increased infection risk.

METHODS:

Using a unique neighborhood boundary, California Medical Service Study Areas, a hotspot analysis, and estimates of neighborhood infection risk ratios were conducted for all CA-Sa SSTIs presented in non-Federal California emergency departments between 2016 and 2019. A Bayesian Poisson regression model evaluated the association between neighborhood-level infection risk and population structure, neighborhood poverty rates, and being a healthcare shortage area.

RESULTS:

Emergency departments in more rural and mountainous parts of California experienced a higher burden of CA-Sa SSTIs between 2016 and 2019. Neighborhoods with high infection rates were more likely to have a high percentage of adults living below the federal poverty level and be a designated healthcare shortage area. Measures of population structure were not associated with infection risk in California neighborhoods.

CONCLUSIONS:

Our results highlight a potential change in the epidemiology of CA-Sa SSTIs in California emergency departments. Future studies should investigate the CA-Sa burden in other geographies to identify whether this shift in epidemiology holds across other states and populations. Further, a more thorough evaluation of potential mechanisms for the clustering of infections seen across California neighborhoods is needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Infecciones de los Tejidos Blandos / Staphylococcus aureus Resistente a Meticilina Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans País/Región como asunto: America do norte Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones Estafilocócicas / Infecciones de los Tejidos Blandos / Staphylococcus aureus Resistente a Meticilina Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans País/Región como asunto: America do norte Idioma: En Revista: BMC Public Health Asunto de la revista: SAUDE PUBLICA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido