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The emergence of community-associated methicillin-resistant S. aureus was associated with dramatically increased skin and soft tissue infection (SSTI) incidence in the first few years of the 21st century in the U.S. However, subsequent trends are poorly understood. Miller et al. (2015) examined ambulatory and inpatient data of more than 48 million persons years aged 0-64 years from the HealthCore Integrated Research Database (HIRD) between 2005 and 2010. Data were extracted from medical, pharmacy and eligibility databases. The researchers quantified SSTI incidence, type and complications and comparative incidence trends for urinary tract infections (UTIs) and pneumonia.
A total of 2,301,803 SSTIs were identified. Most SSTIs (95 percent) were treated in the ambulatory setting and most (60 percent) were categorized as abscesses or cellulitis. During the study period, SSTI incidence remained relatively stable from 47.9 (95% CI: 47.8–48.1) cases/1,000 PY in 2005 to 48.5 cases/1,000 PY (95% CI: 48.3–48.6) in 2010). Persons aged 45-64 years had the highest incidence of both ambulatory-treated and inpatient-treated SSTIs (51.2 (95% CI: 51.1–51.3) and 3.87 (95% CI: 3.84–3.90) cases/1,000 PY, respectively). SSTI complications such as myositis, gangrene, and sepsis occurred in 0.93% (95 % CI: 0.92–0.94%) and 16.92 % (95% CI: 16.87–16.97%) of ambulatory-treated and inpatient-treated patients, respectively. SSTI incidence was approximately twice that of UTIs and tenfold of that of pneumonia.
The researchers conclude that among the study's arge, diverse population of persons less than 65 years, SSTI incidence 2005 through 2010 has remained relatively constant at approximately 4.8 SSTIs per 100 person years, suggesting that previously observed increases in SSTI incidence remain sustained. Their research was published in BMC Infectious Diseases.
Reference: Miller LG, Eisenberg DF, Liu H, Chang CL, Wang Y, Luthra R, Wallace A, Fang C, Singer J and Suaya JA. Incidence of skin and soft tissue infections in ambulatory and inpatient settings, 2005–2010. BMC Infectious Diseases 2015, 15:362 doi:10.1186/s12879-015-1071-0