Community-acquired Staphylococcus aureus skin and soft tissue infection risk assessment using hotspot analysis and risk maps : the case of California emergency departments
© 2024. The Author(s)..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
BMC public health - 24(2024), 1 vom: 09. Jan., Seite 123 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Morgan Bustamante, Brittany L [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 11.01.2024 Date Revised 17.01.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1186/s12889-023-17336-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366860593 |
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| 245 | 1 | 0 | |a Community-acquired Staphylococcus aureus skin and soft tissue infection risk assessment using hotspot analysis and risk maps |b the case of California emergency departments |
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| 500 | |a Date Completed 11.01.2024 | ||
| 500 | |a Date Revised 17.01.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a CA-MRSA | |
| 650 | 4 | |a CA-MSSA | |
| 650 | 4 | |a Geographic disparities | |
| 650 | 4 | |a Hotspot analysis | |
| 650 | 4 | |a Medical service study areas | |
| 650 | 4 | |a Place-based determinants | |
| 650 | 4 | |a Skin and soft tissue Infections | |
| 650 | 4 | |a Spatial analysis | |
| 650 | 4 | |a Staphylococcus aureus | |
| 700 | 1 | |a Fejerman, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a May, Larissa |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-López, Beatriz |e verfasserin |4 aut | |
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