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Increasing hospitalizations and general practice prescriptions for community-onset staphylococcal disease, England.

Hayward A, Knott F, Petersen I, Livermore DM, Duckworth G, Islam A, Johnson AM - Emerging Infect. Dis. (2008)

Bottom Line: Admission rates increased 3-fold for abscesses and cellulitis and 1.5-fold for bone and joint infections.In primary care settings during 1991-2006, floxacillin prescriptions increased 1.8-fold and fusidic acidprescriptions 2.5-fold.We identified a previously undescribed but major increase in pathogenic community-onset staphylococcal disease over the past 15 years.

View Article: PubMed Central - PubMed

Affiliation: University College London Centre for Infectious Disease Epidemiology, London, UK. a.hayward@pcps.ucl.ac.uk

ABSTRACT
Rates of hospital-acquired staphylococcal infection increased throughout the 1990s; however, information is limited on trends in community-onset staphylococcal disease in the United Kingdom. We used Hospital Episode Statistics to describe trends in hospital admissions for community-onset staphylococcal disease and national general practice data to describe trends in community prescribing for staphylococcal disease. Hospital admission rates for staphyloccocal septicemia, staphylococcal pneumonia, staphylococcal scalded-skin syndrome, and impetigo increased >5-fold. Admission rates increased 3-fold for abscesses and cellulitis and 1.5-fold for bone and joint infections. In primary care settings during 1991-2006, floxacillin prescriptions increased 1.8-fold and fusidic acidprescriptions 2.5-fold. The increases were not matched by increases in admission rates for control conditions. We identified a previously undescribed but major increase in pathogenic community-onset staphylococcal disease over the past 15 years. These trends are of concern given the international emergence of invasive community-onset staphylococcal infections.

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A) Age-standardized admission ratios for community-onset infections identified as or likely to be caused by staphylococci. B) Age-standardized admission ratios for community-onset control conditions. SSSS, staphylococcal scalded-skin syndrome.
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Figure 1: A) Age-standardized admission ratios for community-onset infections identified as or likely to be caused by staphylococci. B) Age-standardized admission ratios for community-onset control conditions. SSSS, staphylococcal scalded-skin syndrome.

Mentions: For all staphylococcal diseases from 1990–2001 to 2003–04, we found increasing admission trends. These trends are illustrated in Figure 1, panel A, which shows age-standardized hospital admission ratios for suspected staphylococcal disease, and in Table 1, which compares the number of admissions and standardized admission rates in baseline periods and in 2003–04 and shows the standardized admission ratios. For staphylococcal septicemia, staphylococcal pneumonia, impetigo, and SSSS, increases in admission rates were >5-fold over the study period; for abscesses, furuncles, carbuncles, and cellulitis, the increases were nearly 3-fold; for bone and joint infections, the increase was >50%. There were no similar increases in admission rates for the control conditions in general, although there was a 3-fold increase in admissions for septicemia not attributed to staphylococci (Table 1; Figure 1, panel B). However, most septicemias recorded in HES have no causative organism specified (68% in 1989–90 vs. 65% in 2003–04), and many of these will in fact have been caused by staphylococci. This lack of data on the organisms that cause septicemia may have masked an even greater increase in staphylococcal septicemias.


Increasing hospitalizations and general practice prescriptions for community-onset staphylococcal disease, England.

Hayward A, Knott F, Petersen I, Livermore DM, Duckworth G, Islam A, Johnson AM - Emerging Infect. Dis. (2008)

A) Age-standardized admission ratios for community-onset infections identified as or likely to be caused by staphylococci. B) Age-standardized admission ratios for community-onset control conditions. SSSS, staphylococcal scalded-skin syndrome.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2600225&req=5

Figure 1: A) Age-standardized admission ratios for community-onset infections identified as or likely to be caused by staphylococci. B) Age-standardized admission ratios for community-onset control conditions. SSSS, staphylococcal scalded-skin syndrome.
Mentions: For all staphylococcal diseases from 1990–2001 to 2003–04, we found increasing admission trends. These trends are illustrated in Figure 1, panel A, which shows age-standardized hospital admission ratios for suspected staphylococcal disease, and in Table 1, which compares the number of admissions and standardized admission rates in baseline periods and in 2003–04 and shows the standardized admission ratios. For staphylococcal septicemia, staphylococcal pneumonia, impetigo, and SSSS, increases in admission rates were >5-fold over the study period; for abscesses, furuncles, carbuncles, and cellulitis, the increases were nearly 3-fold; for bone and joint infections, the increase was >50%. There were no similar increases in admission rates for the control conditions in general, although there was a 3-fold increase in admissions for septicemia not attributed to staphylococci (Table 1; Figure 1, panel B). However, most septicemias recorded in HES have no causative organism specified (68% in 1989–90 vs. 65% in 2003–04), and many of these will in fact have been caused by staphylococci. This lack of data on the organisms that cause septicemia may have masked an even greater increase in staphylococcal septicemias.

Bottom Line: Admission rates increased 3-fold for abscesses and cellulitis and 1.5-fold for bone and joint infections.In primary care settings during 1991-2006, floxacillin prescriptions increased 1.8-fold and fusidic acidprescriptions 2.5-fold.We identified a previously undescribed but major increase in pathogenic community-onset staphylococcal disease over the past 15 years.

View Article: PubMed Central - PubMed

Affiliation: University College London Centre for Infectious Disease Epidemiology, London, UK. a.hayward@pcps.ucl.ac.uk

ABSTRACT
Rates of hospital-acquired staphylococcal infection increased throughout the 1990s; however, information is limited on trends in community-onset staphylococcal disease in the United Kingdom. We used Hospital Episode Statistics to describe trends in hospital admissions for community-onset staphylococcal disease and national general practice data to describe trends in community prescribing for staphylococcal disease. Hospital admission rates for staphyloccocal septicemia, staphylococcal pneumonia, staphylococcal scalded-skin syndrome, and impetigo increased >5-fold. Admission rates increased 3-fold for abscesses and cellulitis and 1.5-fold for bone and joint infections. In primary care settings during 1991-2006, floxacillin prescriptions increased 1.8-fold and fusidic acidprescriptions 2.5-fold. The increases were not matched by increases in admission rates for control conditions. We identified a previously undescribed but major increase in pathogenic community-onset staphylococcal disease over the past 15 years. These trends are of concern given the international emergence of invasive community-onset staphylococcal infections.

Show MeSH
Related in: MedlinePlus