Department of Surgery, Feinberg School of Medicine, Northwestern University, Children's Memorial Hospital, Chicago, IL 60614, USA.
J Pediatr Surg. 2011 Oct;46(10):1935-41. doi: 10.1016/j.jpedsurg.2011.05.008.
The number of children requiring treatment of skin and soft tissue infections (SSTIs) has increased since the emergence of methicillin-resistant Staphylococcus aureus.
The 2000, 2003, and 2006 Kids' Inpatient Databases were queried for patients with a primary diagnosis of SSTI. Weighted data were analyzed to estimate temporal changes in incidence, incision and drainage (I&D) rate, and economic burden. Factors associated with I&D were analyzed by multivariable logistic regression.
Pediatric SSTI admissions increased (1) in number, (2) as a fraction of all hospital admissions, and (3) in incidence per 100,000 children from the years 2000 (17,525 ± 838; 0.65%; 23.2) to 2003 (27,463 ± 1652; 0.99%; 36.2) and 2006 (48,228 ± 2223; 1.77%; 62.7). Children younger than 3 years accounted for 49.6% of SSTI admissions in 2006, up from 32.5% in 2000. Utilization of I&D increased during the study period from 26.0% to 43.8%. Factors most associated with requiring I&D were age less than 3 years and calendar year 2006 (both P < .001). Hospital costs per patient increased over time and were higher in the group of patients who required I&D ($4296 ± $84 vs $3521 ± $81; P < .001; year 2006). Aggregate national costs reached $184.0 ± $9.4 million in 2006.
The recent spike in pediatric SSTIs has disproportionately affected children younger than 3 years, and an increasing fraction of these children require I&D. The national economic burden is substantial.
耐甲氧西林金黄色葡萄球菌出现以来，需要治疗皮肤和软组织感染（SSTIs）的儿童数量有所增加。
对 2000 年、2003 年和 2006 年儿童住院数据库进行了查询，以确定 SSTI 的主要诊断为患者。对加权数据进行了分析，以估计发病率、切开引流（I&D）率和经济负担的时间变化。通过多变量逻辑回归分析与 I&D 相关的因素。
儿科 SSTI 入院人数增加：（1）数量增加，（2）占所有住院人数的比例增加，（3）每 100,000 名儿童的发病率从 2000 年（17,525±838；0.65%；23.2）到 2003 年（27,463±1652；0.99%；36.2）和 2006 年（48,228±2223；1.77%；62.7）增加。2006 年，年龄小于 3 岁的儿童占 SSTI 入院人数的 49.6%，高于 2000 年的 32.5%。在研究期间，切开引流的使用率从 26.0%增加到 43.8%。与需要切开引流最相关的因素是年龄小于 3 岁和 2006 年（均 P<.001）。患者的人均住院费用随着时间的推移而增加，需要切开引流的患者费用更高（4296±84 美元对 3521±81 美元；P<.001；2006 年）。2006 年全国总费用达到 1.8409 亿美元。
最近儿科 SSTIs 的激增不成比例地影响了 3 岁以下的儿童，其中越来越多的儿童需要 I&D。国家经济负担巨大。
