1080. Incidence rates of skin and soft-tissue infections in diabetics and non-diabetics in a large commercially insured US population
Session: Poster Abstract Session: Infection in Immunocompromised Patients
Saturday, October 22, 2011
Room: Poster Hall B1
Background: With the advent and spread of community-associated methicillin-resistantance in S. aureus (SA), skin and soft tissue infections (SSTIs) have risen in incidence. We analyzed the incidence of outpatient-diagnosed SSTIs in diabetic and non-diabetic populations.

Methods: We used data from HealthCore Integrated Research Database from 2005 to 2008, which contains claims for over 24 million persons aged 0-64 years. Based on ICD-9 codes, we identified medical claims for SSTIs in both inpatient and outpatient settings. SSTIs claims were bundled into episodes. Incidence rates were calculated for diabetic and non-diabetic populations by age group.

Results: Overall prevalence of diabetes in our population was 4.97%. Of the 1,506,882 SSTIs we identified, 12.2% occured in diabetics. SSTIs incidence was 2.7 times higher in diabetics than in non-diabetics (105.1 vs. 38.9/1000 person years (PY), p<0.01). Higher risk of SSTI among those with diabetes was across all age groups (0-17, 18-44, and 45-64 years of age). Among the diabetics and non-diabetic groups, abcess /cellulitis were the most common SSTIs (64.3% and 59.4%). Other SSTIs episodes included decubitis ulcer represented (7.8% and 0.9%), surgical site, device or graft infections represented (6.3% and 3.3%), folliculitis (6.8% and 13.0%), furuncle (2.9% and 3.5%), mastitis (1.8% and 2.5%), and impetigo (1.6% and 7.7%),   in diabetics and non-diabetics, respectively. Other miscellaneous SSTIs  represented 8.4% and 9.8% in diabetics and non-diabetics, respectively.

Conclusion: SSTI burden is substantial, with an average of nearly 10% of diabetic and 4% of non-diabetic members having an SSTI requiring medical attention annually. The high incidence of SSTIs in diabetics was seen across all age-groups.Preventitive measures including interventions that identify and modify risks factors for developing SSTIs, specially in diabetics, may reduce the incidence, morbidity, and healthcare expenditures of SSTIs.

Subject Category: J. Clinical practice issues

Jose A. Suaya, MD, PhD, US Global Health Outcomes, GlaxoSmithKline, Philadelphia, PA, Debra Eisenberg, MS, PhD, Outcomes Research, HealthCore Inc, Wilmington, DE, Christy Fang, MS, Healthcore Inc., Wilmington, DE and Loren Miller, MD, MPH, Harbor-University of California, Los Angeles Medical Center, Torrance, CA


J. A. Suaya, GlaxoSmithKline: Employee, Salary

D. Eisenberg, Healthcore Inc.: Employee, Salary

C. Fang, None

L. Miller, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.