Space-time trends of community-onset Staphylococcus aureus infections in children: a group-based trajectory modeling approach

• Published in: Annals of epidemiology Vol. 82; pp. 45 - 53.e1
• Main Authors: Immergluck, Lilly Cheng, Geng, Ruijin, Li, Chaohua, Edelson, Mike, Lin, Xiting, Waller, Lance A., Rust, George, Xu, Junjun, Leong, Traci, Baltrus, Peter
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2023
• Subjects: Anti-Bacterial Agents - therapeutic use; Child; Community onset methicillin-resistant Staphylococcus aureus; Community onset methicillin-susceptible Staphylococcus aureus; Community-Acquired Infections - drug therapy; Community-Acquired Infections - epidemiology; Group-based trajectory modeling; Hotspot mappin; Humans; Methicillin; Methicillin-Resistant Staphylococcus aureus; Retrospective Studies; Staphylococcal Infections - drug therapy; Staphylococcal Infections - epidemiology; Staphylococcus aureus; United States - epidemiology; United States; LTDB; CHOA; EHR; MSSA; S. aureus; SSTI; Group-based trajectory modeling; GBTM; MRSA; CO-MRSA; MSA; Community onset methicillin-susceptible Staphylococcus aureus; CO-MSSA; Community onset methicillin-resistant Staphylococcus aureus; Hotspot mappin; ED
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2023.03.001

Staphylococcus aureus (S. aureus) remains a serious cause of infections in the United States and worldwide. In the United States, methicillin-resistant S. aureus (MRSA) is the leading cause of skin and soft tissue infections. This study identifies ‘best’ to ‘worst’ infection trends from 2002 to 2016, using group-based trajectory modeling approach. Electronic health records of children living in the southeastern United States with S. aureus infections from 2002 to 2016 were retrospectively studied, by applying a group-based trajectory model to estimate infection trends (low, high, very high), and then assess spatial significance of these trends at the census tract level; we focused on community-onset infections and not those considered healthcare acquired. Three methicillin-susceptible S. aureus (MSSA) infection trends (low, high, very high) and three MRSA trends (low, high, very high) were identified from 2002 to 2016. Among census tracts with community-onset S. aureus cases, 29% of tracts belonged to the best trend (low infection) for both methicillin-resistant S. aureus and methicillin-susceptible S. aureus; higher proportions occurring in the less densely populated areas. Race disparities were seen with the worst methicillin-resistant S. aureus infection trends and were more often in urban areas. Group-based trajectory modeling identified unique trends of S. aureus infection rates over time and space, giving insight into the associated population characteristics which reflect these trends of community-onset infection. [Display omitted] •Group-based trajectory models determined spatiotemporal S. aureus infections.•Community-onset S. aureus infection trends varied from low, high, and very high.•Disparities in S. aureus infection trends differed in rural compared to urban areas.•Antibiotic-resistant S. aureus trends occurred in census tracts with higher blacks.•Group-based trajectory models showed the epidemic ‘trajectory’ curve for S. aureus.