Miller LG, Eisenberg DF, Liu H, Chang CL, Wang Y, Luthra R, Wallace A, Fang C, Singer J, Suaya JA, et al.
BMC infectious diseases. Date of publication 2015 Aug 21;volume 15():362.
1. BMC Infect Dis. 2015 Aug 21;15:362. doi: 10.1186/s12879-015-1071-0.
Incidence of skin and soft tissue infections in ambulatory and inpatient
settings, 2005-2010.
Miller LG(1)(2)(3), Eisenberg DF(4), Liu H(5)(6)(7), Chang CL(8), Wang Y(9),
Luthra R(10), Wallace A(11), Fang C(12), Singer J(13), Suaya JA(14)(15).
Author information:
(1)Infectious Disease Clinical Outcomes Research Unit (ID-CORE), Division of
Infectious Diseases, Los Angeles BioMedical Research Center at Harbor-UCLA,
Torrance, CA, USA. Lgmiller@ucla.edu.
(2)Division of Infectious Diseases, Harbor-UCLA Medical Center, 1000 W Carson St
Box 466, Torrance, CA, 90509, USA. Lgmiller@ucla.edu.
(3)David Geffen School of Medicine at UCLA, Los Angeles, USA. Lgmiller@ucla.edu.
(4)HealthCore, Inc, Wilmington, DE, USA. DEisenberg@healthcore.com.
(5)Division of Public Health, School of Dentistry at UCLA, Los Angeles, USA.
hhliu@dentistry.ucla.edu.
(6)Division of General Internal Medicine, David Geffen School of Medicine at
UCLA, Los Angeles, USA. hhliu@dentistry.ucla.edu.
(7)Department of Biostatistics, Fielding School of Public Health at UCLA, Los
Angeles, USA. hhliu@dentistry.ucla.edu.
(8)HealthCore, Inc, Wilmington, DE, USA. ginaclc@hotmail.com.
(9)Department of Biostatistics, Fielding School of Public Health at UCLA, Los
Angeles, USA. wangyan@ucla.edu.
(10)HealthCore, Inc, Wilmington, DE, USA. luthrarakesh1984@gmail.com.
(11)HealthCore, Inc, Wilmington, DE, USA. Awallace@healthcore.com.
(12)HealthCore, Inc, Wilmington, DE, USA. echerry@gmail.com.
(13)HealthCore, Inc, Wilmington, DE, USA. JSinger@healthcore.com.
(14)U.S. Health Outcomes, GlaxoSmithKline, Research Triangle Park, Philadelphia,
PA, USA. jose.2.suaya@gsk.com.
(15)U.S. Health Outcomes, NACMA, Vaccines, GlaxoSmithKline, Philadelphia, PA,
USA. jose.2.suaya@gsk.com.
BACKGROUND: 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 21(st) century in the U.S.
However, subsequent trends are poorly understood.
METHODS: We examined ambulatory and inpatient data of over 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. We quantified SSTI incidence, type, and complications and
comparative incidence trends for urinary tract infections (UTIs) and pneumonia.
RESULTS: A total of 2,301,803 SSTIs were identified. Most SSTIs (95 %) were
treated in the ambulatory setting and most (60 %) 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.
CONCLUSIONS: Among our large, 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.
DOI: 10.1186/s12879-015-1071-0
PMCID: PMC4546168
PMID: 26293161 [Indexed for MEDLINE]
