Miller Loren G, Eisenberg Debra F, Liu Honghu, Chang Chun-Lan, Wang Yan, Luthra Rakesh, Wallace Anna, Fang Christy, Singer Joseph, Suaya Jose A
Infectious Disease Clinical Outcomes Research Unit (ID-CORE), Division of Infectious Diseases, Los Angeles BioMedical Research Center at Harbor-UCLA, Torrance, CA, USA.
Division of Infectious Diseases, Harbor-UCLA Medical Center, 1000 W Carson St Box 466, Torrance, CA, 90509, USA.
BMC Infect Dis. 2015 Aug 21;15:362. doi: 10.1186/s12879-015-1071-0.
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.
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.
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.
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.
21世纪头几年，社区获得性耐甲氧西林金黄色葡萄球菌的出现与美国皮肤和软组织感染（SSTI）发病率急剧上升有关。然而，后续趋势尚不清楚。
我们研究了2005年至2010年间HealthCore综合研究数据库（HIRD）中超过4800万人年的0至64岁门诊和住院数据。数据从医疗、药房和资格数据库中提取。我们对SSTI发病率、类型和并发症以及尿路感染（UTI）和肺炎的比较发病率趋势进行了量化。
共识别出2301803例SSTI。大多数SSTI（95%）在门诊治疗，大多数（60%）归类为脓肿或蜂窝织炎。在研究期间，SSTI发病率相对稳定，从2005年的47.9（95%CI：47.8 - 48.1）例/1000人年降至2010年的48.5例/1000人年（95%CI：48.3 - 48.6）。45 - 64岁的人门诊治疗和住院治疗的SSTI发病率最高（分别为51.2（95%CI：51.1 - 51.3）和3.87（95%CI：3.84 - 3.90）例/1000人年）。SSTI并发症如肌炎、坏疽和败血症分别发生在门诊治疗患者的0.93%（95%CI：0.92 - 0.94%）和住院治疗患者的16.92%（95%CI：16.87 - 16.97%）。SSTI发病率约为UTI的两倍，肺炎的十倍。
在我们这个年龄小于65岁的庞大、多样化人群中，2005年至2010年SSTI发病率保持相对稳定，约为每100人年4.8例SSTI，这表明之前观察到的SSTI发病率上升趋势仍在持续。
