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Open Access Highly Accessed Research article

Incidence and cost of hospitalizations associated with Staphylococcus aureus skin and soft tissue infections in the United States from 2001 through 2009

Jose A Suaya1*, Robertino M Mera2, Adrian Cassidy3, Patrick O’Hara4, Heather Amrine-Madsen5, Stuart Burstin6 and Loren G Miller7

Author Affiliations

1 Health Outcomes, North America Vaccine Development, GlaxoSmithKline, Philadelphia, PA, USA

2 Gastroenterology Department, Vanderbilt University, Nashville, TN, USA

3 GSK Vaccines, Wavre, Belgium

4 Research and Development, GlaxoSmithKline, Philadelphia, PA, USA

5 Research and Development, GlaxoSmithKline, RTP, Durham, NC, USA

6 North America Vaccine Development, GlaxoSmithKline Vaccines, King of Prussia, PA, USA

7 Los Angeles BioMedical Research Center at Harbor-UCLA Medical Center; Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

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BMC Infectious Diseases 2014, 14:296  doi:10.1186/1471-2334-14-296

Published: 2 June 2014

Abstract

Background

The emergence of community-associated methicillin-resistant Staphylococcus aureus (SA) and its role in skin and soft tissue infections (SSTIs) accentuated the role of SA-SSTIs in hospitalizations.

Methods

We used the Nationwide Inpatient Sample and Census Bureau data to quantify population-based incidence and associated cost for SA-SSTI hospitalizations.

Results

SA-SSTI associated hospitalizations increased 123% from 160,811 to 358,212 between 2001 and 2009, and they represented an increasing share of SA- hospitalizations (39% to 51%). SA-SSTI incidence (per 100,000 people) doubled from 57 in 2001 to 117 in 2009 (p < 0.01). A significant increase was observed in all age groups. Adults aged 75+ years and children 0–17 years experienced the lowest (27%) and highest (305%) incidence increase, respectively. However, the oldest age group still had the highest SA-SSTI hospitalization incidence across all study years. Total annual cost of SA-SSTI hospitalizations also increased and peaked in 2008 at $4.84 billion, a 44% increase from 2001. In 2009, the average associated cost of a SA-SSTI hospitalization was $11,622 (SE = $200).

Conclusion

There has been an increase in the incidence and associated cost of SA-SSTI hospitalizations in U.S.A. between 2001 and 2009, with the highest incidence increase seen in children 0–17 years. However, the greatest burden was still seen in the population over 75 years. By 2009, SSTI diagnoses were present in about half of all SA-hospitalizations.

Keywords:
Staphylococcus aureus; Skin and soft tissue infections (SSTIs); Hospitalizations; Incidence; Cost