Tropical Diseases Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
PLoS Negl Trop Dis. 2020 Dec 9;14(12):e0008887. doi: 10.1371/journal.pntd.0008887. eCollection 2020 Dec.
Scabies is an important predisposing factor for impetigo but its role in more serious skin and soft tissue infections (SSTIs) is not well understood. Information is limited on incidence of SSTIs in the presence of endemic scabies. We conducted a prospective study of hospital admissions for SSTIs in the Northern Division of Fiji (population: 131,914). Prospective surveillance for admissions with impetigo, abscess, cellulitis, wound infection, pyomyositis, necrotizing fasciitis, infected scabies, and crusted scabies was conducted at the Division's referral hospital between 2018 to 2019. Information was collected on demographic characteristics, clinical features, microbiology, treatment and outcomes. Over the study period, 788 SSTI admissions were recorded corresponding to a population incidence 647 per 100,000 person-years (95%CI 571-660). Incidence was highest at the extremes of age with peak incidence in children aged <5 years (908 per 100,000) and those aged ≥65 years (1127 per 100,000). Incidence was 1.7 times higher among the Indigenous Fijian population (753 per 100,000) compared to other ethnicities (442 per 100,000). Overall case fatality rate was 3.3%, and 10.8% for those aged ≥65 years. Scabies was diagnosed concurrently in 7.6% of all patients and in 24.6% of admitted children <5 years. There is a very high burden of hospital admissions for SSTIs in Fiji compared to high-income settings especially among the youngest, oldest and indigenous population which is concordant with scabies and impetigo distribution in this population. Our findings highlight the need for strategies to reduce the burden of SSTIs in Fiji and similar settings.
疥疮是脓疱疮的一个重要诱发因素，但它在更严重的皮肤和软组织感染（SSTI）中的作用尚未得到充分了解。在地方性疥疮流行的情况下，关于 SSTI 的发病率的信息有限。我们对斐济北区（人口：131914 人）的 SSTI 住院患者进行了一项前瞻性研究。在该地区的转诊医院，对脓疱疮、脓肿、蜂窝织炎、伤口感染、肌脓肿、坏死性筋膜炎、感染性疥疮和结痂性疥疮的住院患者进行了前瞻性监测，监测时间为 2018 年至 2019 年。收集了人口统计学特征、临床特征、微生物学、治疗和结果等信息。在研究期间，共记录了 788 例 SSTI 住院患者，发病率为每 100000 人年 647 例（95%CI 571-660）。年龄较大的人群发病率最高，5 岁以下儿童的发病率最高（908/100000），≥65 岁人群的发病率最高（1127/100000）。与其他族裔群体相比，斐济原住民（753/100000）的发病率高 1.7 倍（753/100000）。总体病死率为 3.3%，≥65 岁患者的病死率为 10.8%。所有患者中有 7.6%同时诊断出疥疮，5 岁以下住院患儿中有 24.6%同时诊断出疥疮。与高收入国家相比，斐济的 SSTI 住院患者负担非常重，尤其是在最年轻、最年长和原住民人群中，这与该人群中疥疮和脓疱疮的分布情况一致。我们的研究结果强调了在斐济和类似环境中需要采取策略来减轻 SSTI 的负担。
