{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T17:50:16Z","timestamp":1760205016131,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,15]],"date-time":"2019-06-15T00:00:00Z","timestamp":1560556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K24-AI121296","R01AI134637","R21AI143229"],"award-info":[{"award-number":["K24-AI121296","R01AI134637","R21AI143229"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Skin and soft tissue infections (SSTIs) disproportionately impact patients with human immunodeficiency virus (HIV). Recent declines in the incidence of SSTIs have been noted in the non-HIV population. We sought to study the epidemiology and microbiology of SSTIs in a population of 8597 patients followed for HIV primary care in a large, urban county system from January 2009 to December 2014.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>SSTIs were identified from the electronic medical record by use of International Classification of Diseases-9 billing codes. Charts were reviewed to confirm each patient\u2019s diagnosis of acute SSTI and abstract culture and susceptibility data. We calculated the yearly SSTI incidences using Poisson regression with clustering by patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 2202 SSTIs identified. Of 503 (22.8%) cultured SSTIs, 332 (66.0%) recovered Staphylococcus aureus as a pathogen, of which 287\/332 (86.4%) featured S. aureus as the sole isolated organism. Among the S. aureus isolates that exhibited antibiotic susceptibilities, 231\/331 (69.8%) were methicillin resistant, and the proportion did not change by year. The observed incidence of SSTI was 78.0 per 1000 person-years (95% confidence interval 72.9\u201383.4) and declined from 96.0 infections per 1000 person-years in 2009 to 56.5 infections per 1000 person-years in 2014 (P &amp;lt; .001). Other significant predictors of SSTI incidences in both univariate as well as multivariate analyses included a low CD4 count, high viral load, and not being a Spanish-speaking Hispanic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>SSTIs remain a significant problem in the outpatients living with HIV, although rates of SSTIs appear to have declined by approximately 40% between 2009 and 2014.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz509","type":"journal-article","created":{"date-parts":[[2019,6,14]],"date-time":"2019-06-14T19:14:56Z","timestamp":1560539696000},"page":"1985-1992","source":"Crossref","is-referenced-by-count":10,"title":["Skin and Soft Tissue Infection in People Living With Human Immunodeficiency Virus in a Large, Urban, Public Healthcare System in Houston, Texas, 2009\u20132014"],"prefix":"10.1093","volume":"70","author":[{"given":"Vagish","family":"Hemmige","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Montefiore Medical Center, Bronx, New York"},{"name":"Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar A","family":"Arias","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Center for Antimicrobial Resistance and Microbial Genomics, University of Texas Health McGovern Medical School, Houston"},{"name":"Center for Infectious Diseases, University of Texas Health, School of Public Health, Houston"},{"name":"Molecular Genetics and Antimicrobial Resistance Unit-International Center for Microbial Genomics, Universidad El Bosque, Bogota, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siavash","family":"Pasalar","sequence":"first","affiliation":[{"name":"Harris Health System, Department of Medicine, Baylor College of Medicine, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas P","family":"Giordano","sequence":"first","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas"},{"name":"Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Administration Medical Center, Houston, Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,15]]},"reference":[{"key":"2020041500553018000_CIT0001","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1001\/jama.279.8.593","article-title":"Community-acquired methicillin-resistant Staphylococcus aureus in children with no identified predisposing risk","volume":"279","author":"Herold","year":"1998","journal-title":"JAMA"},{"key":"2020041500553018000_CIT0002","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1128\/CMR.00081-09","article-title":"Community-associated methicillin-resistant Staphylococcus aureus: epidemiology and clinical consequences of an emerging epidemic","volume":"23","author":"David","year":"2010","journal-title":"Clin Microbiol Rev"},{"key":"2020041500553018000_CIT0003","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1001\/archinte.168.14.1585","article-title":"National trends in ambulatory visits and antibiotic prescribing for skin and soft-tissue infections","volume":"168","author":"Hersh","year":"2008","journal-title":"Arch Intern Med"},{"key":"2020041500553018000_CIT0004","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1177\/1078345811401363","article-title":"The rise of methicillin-resistant Staphylococcus aureus in U.S. correctional populations","volume":"17","author":"Malcolm","year":"2011","journal-title":"J Correct Health Care"},{"key":"2020041500553018000_CIT0005","doi-asserted-by":"crossref","first-page":"249","DOI":"10.7326\/0003-4819-148-4-200802190-00204","article-title":"Emergence of multidrug-resistant, community-associated, methicillin-resistant Staphylococcus aureus clone USA300 in men who have sex with men","volume":"148","author":"Diep","year":"2008","journal-title":"Ann Intern Med"},{"key":"2020041500553018000_CIT0006","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1001\/archinte.167.10.1026","article-title":"Community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections at a public hospital: do public housing and incarceration amplify transmission?","volume":"167","author":"Hota","year":"2007","journal-title":"Arch Intern Med"},{"key":"2020041500553018000_CIT0007","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1086\/651076","article-title":"Community-associated methicillin-resistant Staphylococcus aureus and HIV: intersecting epidemics","volume":"50","author":"Popovich","year":"2010","journal-title":"Clin Infect Dis"},{"key":"2020041500553018000_CIT0008","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1097\/QAD.0b013e328343c595","article-title":"The rise and fall of methicillin-resistant Staphylococcus aureus infections in HIV patients","volume":"25","author":"Hidron","year":"2011","journal-title":"AIDS"},{"key":"2020041500553018000_CIT0009","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/MD.0b013e318238dc2c","article-title":"Association of methicillin-resistant Staphylococcus aureus (MRSA) colonization with high-risk sexual behaviors in persons infected with human immunodeficiency virus (HIV)","volume":"90","author":"Crum-Cianflone","year":"2011","journal-title":"Medicine (Baltimore)"},{"key":"2020041500553018000_CIT0010","doi-asserted-by":"crossref","first-page":"ofv148","DOI":"10.1093\/ofid\/ofv148","article-title":"The intersecting epidemics of human immunodeficiency virus, community-associated methicillin-resistant Staphylococcus aureus, and incarceration","volume":"2","author":"Popovich","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"2020041500553018000_CIT0011","doi-asserted-by":"crossref","first-page":"ofv034","DOI":"10.1093\/ofid\/ofv034","article-title":"Specific behaviors predict Staphylococcus aureus colonization and skin and soft tissue infections among human immunodeficiency virus-infected persons","volume":"2","author":"Crum-Cianflone","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"2020041500553018000_CIT0012","doi-asserted-by":"crossref","first-page":"e1005580","DOI":"10.1371\/journal.ppat.1005580","article-title":"MRSA infections in HIV-infected people are associated with decreased MRSA-specific Th1 immunity","volume":"12","author":"Utay","year":"2016","journal-title":"PLOS Pathog"},{"key":"2020041500553018000_CIT0013","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1258\/ijsa.2011.011360","article-title":"Skin and soft tissue infections among HIV-infected persons in the late combination antiretroviral therapy era","volume":"23","author":"Crum-Cianflone","year":"2012","journal-title":"Int J STD AIDS"},{"key":"2020041500553018000_CIT0014","doi-asserted-by":"crossref","DOI":"10.1093\/cid\/ciy509","article-title":"Decreasing incidence of skin and soft tissue infections at 86 U.S. emergency departments, 2009\u20132014","author":"Morgan","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2020041500553018000_CIT0015","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1017\/S0950268813000228","article-title":"Trends in annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in HIV-infected and HIV-uninfected patients","volume":"141","author":"Delorenze","year":"2013","journal-title":"Epidemiol Infect"},{"key":"2020041500553018000_CIT0016","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1128\/JCM.00044-07","article-title":"Phenotypic prediction rule for community-associated methicillin-resistant Staphylococcus aureus","volume":"45","author":"Popovich","year":"2007","journal-title":"J Clin Microbiol"},{"key":"2020041500553018000_CIT0017","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1056\/NEJMoa1403789","article-title":"Clindamycin versus trimethoprim-sulfamethoxazole for uncomplicated skin infections","volume":"372","author":"Miller","year":"2015","journal-title":"N Engl J Med"},{"key":"2020041500553018000_CIT0018","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1093\/cid\/cit010","article-title":"Community-associated methicillin-resistant Staphylococcus aureus colonization burden in HIV-infected patients","volume":"56","author":"Popovich","year":"2013","journal-title":"Clin Infect Dis"},{"key":"2020041500553018000_CIT0019","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/S2215-0366(16)30101-8","article-title":"Hispanic immigrants in the USA: social and mental health perspectives","volume":"3","author":"Alarc\u00f3n","year":"2016","journal-title":"Lancet Psychiatry"},{"key":"2020041500553018000_CIT0020","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1533-8525.1991.tb00169.x","article-title":"Ethnic enclosure or ethnic competition: ethnic identification among Hispanics in Texas","volume":"32","author":"Hwang","year":"1991","journal-title":"Sociol Q"},{"key":"2020041500553018000_CIT0021","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/MLR.0000000000000511","article-title":"Emergency department use among Hispanic adults: the role of acculturation","volume":"54","author":"Allen","year":"2016","journal-title":"Med Care"},{"key":"2020041500553018000_CIT0022","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1080\/09540121.2018.1442554","article-title":"Single tablet HIV regimens facilitate virologic suppression and retention in care among treatment na\u00efve patients","volume":"30","author":"Hemmige","year":"2018","journal-title":"AIDS Care"},{"key":"2020041500553018000_CIT0023","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1093\/aje\/kwr183","article-title":"Performance of the modified Poisson regression approach for estimating relative risks from clustered prospective data","volume":"174","author":"Yelland","year":"2011","journal-title":"Am J Epidemiol"},{"key":"2020041500553018000_CIT0024","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1093\/cid\/cit779","article-title":"Antiretroviral therapy reduces the rate of hepatic decompensation among HIV- and hepatitis C virus-coinfected veterans","volume":"58","author":"Anderson","year":"2014","journal-title":"Clin Infect Dis"},{"key":"2020041500553018000_CIT0025","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1128\/JCM.43.4.1716-1721.2005","article-title":"Testing for induction of clindamycin resistance in erythromycin-resistant isolates of Staphylococcus aureus","volume":"43","author":"Steward","year":"2005","journal-title":"J Clin Microbiol"},{"key":"2020041500553018000_CIT0026","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s10096-014-2237-1","article-title":"Predictors of skin and soft tissue infections in HIV-infected outpatients in the community-associated methicillin-resistant Staphylococcus aureus era","volume":"34","author":"Hemmige","year":"2015","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2020041500553018000_CIT0027","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/01.qai.0000179464.40948.b9","article-title":"Incidence of and risk factors for clinically significant methicillin-resistant Staphylococcus aureus infection in a cohort of HIV-infected adults","volume":"40","author":"Mathews","year":"2005","journal-title":"J Acquir Immune Defic Syndr (1999)"},{"key":"2020041500553018000_CIT0028","doi-asserted-by":"crossref","first-page":"2889","DOI":"10.1017\/S0950268816000789","article-title":"The complex relationship between CD4 count, HIV viral load, trimethoprim-sulfamethoxazole prophylaxis, and skin-and-soft-tissue infection risk in patients with HIV: insights from a causal diagram and simulation study","volume":"144","author":"Hemmige","year":"2016","journal-title":"Epidemiol Infect"},{"key":"2020041500553018000_CIT0029","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1086\/342196","article-title":"Strains of Staphylococcus aureus obtained from drug-use networks are closely linked","volume":"35","author":"Quagliarello","year":"2002","journal-title":"Clin Infect Dis"},{"key":"2020041500553018000_CIT0030","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s10464-013-9619-x","article-title":"Social isolation and perceived barriers to establishing social networks among Latina immigrants","volume":"53","author":"Hurtado-de-Mendoza","year":"2014","journal-title":"Am J Community Psychol"},{"key":"2020041500553018000_CIT0031","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1080\/13557858.2013.814763","article-title":"Contextualizing nativity status, Latino social ties, and ethnic enclaves: an examination of the \u2018immigrant social ties hypothesis.\u2019","volume":"18","author":"Viruell-Fuentes","year":"2013","journal-title":"Ethn Health"},{"key":"2020041500553018000_CIT0032","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1007\/s40615-016-0229-9","article-title":"Using geographic information systems (GIS) to examine barriers to healthcare access for Hispanic and Latino immigrants in the U.S. south","volume":"4","author":"Edward","year":"2017","journal-title":"J Racial Ethn Health Disparities"},{"key":"2020041500553018000_CIT0033","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1080\/09540121.2014.894617","article-title":"Perceptions of barriers and facilitators to cervical cancer screening among low-income, HIV-infected women from an integrated HIV clinic","volume":"26","author":"Fletcher","year":"2014","journal-title":"AIDS Care"},{"key":"2020041500553018000_CIT0034","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1353\/hpu.0.0312","article-title":"Who uses hospital emergency rooms?: Evidence from Houston\/Harris County Texas","volume":"21","author":"Begley","year":"2010","journal-title":"J Health Care Poor Underserved"},{"key":"2020041500553018000_CIT0035","doi-asserted-by":"crossref","first-page":"128","DOI":"10.3122\/jabfm.2008.02.070149","article-title":"Factors affecting Latino adults\u2019 use of antibiotics for self-medication","volume":"21","author":"Mainous","year":"2008","journal-title":"J Am Board Fam Med"},{"key":"2020041500553018000_CIT0036","doi-asserted-by":"crossref","first-page":"5527","DOI":"10.1128\/AAC.00528-16","article-title":"Nonprescription antimicrobial use in a primary care population in the United States","volume":"60","author":"Zoorob","year":"2016","journal-title":"Antimicrob Agents Chemother"},{"key":"2020041500553018000_CIT0037","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1093\/infdis\/jiw444","article-title":"Life after USA300: the rise and fall of a superbug","volume":"215","author":"Planet","year":"2017","journal-title":"J Infect Dis"},{"key":"2020041500553018000_CIT0038","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1186\/1471-2334-13-171","article-title":"Use of electronic health record data to identify skin and soft tissue infections in primary care settings: a validation study","volume":"13","author":"Levine","year":"2013","journal-title":"BMC Infect Dis"},{"key":"2020041500553018000_CIT0039","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1086\/516778","article-title":"Retention in care: a challenge to survival with HIV infection","volume":"44","author":"Giordano","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2020041500553018000_CIT0040","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1007\/s11606-014-3102-8","article-title":"Accuracy of race, ethnicity, and language preference in an electronic health record","volume":"30","author":"Klinger","year":"2015","journal-title":"J Gen Intern Med"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciz509\/29095055\/ciz509.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/9\/1985\/33045493\/ciz509.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/cid\/article-pdf\/70\/9\/1985\/33045493\/ciz509.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,15]],"date-time":"2020-04-15T04:55:56Z","timestamp":1586926556000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/70\/9\/1985\/5519829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,15]]},"references-count":40,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,6,15]]},"published-print":{"date-parts":[[2020,4,15]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciz509","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"type":"print","value":"1058-4838"},{"type":"electronic","value":"1537-6591"}],"subject":[],"published-other":{"date-parts":[[2020,5,1]]},"published":{"date-parts":[[2019,6,15]]}}}