913. PRONOUNCED INCREASE OF INCIDENCE AND COST ASSOCIATED WITH HOSPITALIZATIONS FOR Staphylococcus aureus SKIN AND SOFT TISSUE INFECTIONS IN US CHILDREN, 2001-2008
Session: Poster Abstract Session: Antimicrobial Utilization and Resistance in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Background:

With the recent emergence of community-associated methicillin-resistant Staphylococcus aureus (MRSA), there has been growing concern about the magnitude of S. aureus skin and soft tissue infections (SA-SSTIs) in children. We examined population-based incidence and cost for SA-SSTIs hospitalizations from 2001 through 2008 in the United States (US).

Methods:

We used data from The Nationwide Inpatient Sample (NIS), which is a Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality, to identify SA-SSTIs hospitalizations, which were defined by the combination of S. aureus and SSTI-specific ICD-9 codes in any listed discharge diagnosis. Census Bureau data were used to quantify the US population < 20 years. Costs were converted to 2010 US dollars.

Results:

SA-SSTI-associated hospitalizations increased by four fold from 9,131 to 36,369 from 2001 to 2008. During this period, SA-SSTIs represented an increasing share of all the S. aureus hospitalizations from 41%% to 67%. Annual SA-SSTI incidence (per 100,000 people) increased from 11 in 2001 to 44 in 2008 (p<0.01).  All age groups had a significant increase in SA-SSTI incidence, peaking in 2005. The lowest and the highest incidence increase were observed in children 10-14 yrs. (246%) and 1-4 yrs. (475%), respectively. In 2008, compared with children 5-9 yrs. (19.3/100,000, reference group), relative risk of SA-SSTI hospitalizations was highest in those age <1 year. (RR=8.0) followed by age groups 1-4 yrs. (RR=4.0), and 15-19 yrs, (RR=2.00, p<0.01 for all comparisons ). For the study population, total annual cost of SA-SSTI hospitalizations peaked in 2005 and totaled $382 million, a 2.6 fold increase from 2001. In 2008, the average cost of a SA-SSTI hospitalization and the annual total US costs due to SA-SSTIs hospitalizations were $7,604 (SE=$628) and $292 million (SE=$35 m), respectively.

Conclusion: 

There has been a dramatic increase in the incidence and cost of SA-SSTIs between 2001 and 2008 in the US. By 2008, SA-SSTIs represented about two-thirds of all SA hospitalizations. Interventions to prevent SA-SSTIs may have major impact on morbidity and healthcare cost.


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Jose A. Suaya, MD, PhD1, Robertino Mera, PhD2, Adrian Cassidy, PhD3, Jean-Etienne Poirrier, PhD3, Stuart Burstin, MD4, Heather Amrine-Madsen, PhD5 and Loren Miller, MD, MPH6,7, (1)US Global Health Outcomes, GlaxoSmithKline, Philadelphia, PA, (2)Research Statistics Unit, GlaxoSmithKline, Durham, NC, (3)GlaxoSmithKline, Wavre, Belgium, (4)GlaxoSmithKline, Philadelphia, PA, (5)GlaxoSmithKline, Durham, NC, (6)Harbor-University of California, Los Angeles Medical Center, Torrance, CA, (7)Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA

Disclosures:

J. A. Suaya, GlaxoSmithKline: Employee, Salary

R. Mera, GlaxoSmithKline : Employee, Salary

A. Cassidy, GlaxoSmithKline: Employee and Shareholder, Salary

J. E. Poirrier, GlaxoSmithKline: Employee and Shareholder, Salary

S. Burstin, GlaxoSmithKline: Employee and Shareholder, Salary

H. Amrine-Madsen, GlaxoSmithKline: Employee and Shareholder, Salary

L. Miller, None

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