1533. Deaths from S. aureus-Associated Necrotizing Fasciitis in the United States, 2003-2013
Session: Poster Abstract Session: Clinical Infectious Diseases: Soft Tissue Infections (ABSSSIs)
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • Nida_idsa_poster_rev 100pct.pdf (191.5 kB)
  • Background: Necrotizing fasciitis (NF) is a life-threatening infection requiring urgent surgical and medical therapy. S. aureus is an uncommon microbiologic cause of NF overall, but recent reports have raised concerns regarding the emergence of severe skin and soft tissue infections caused by community-associated methicillin resistant S. aureus (MRSA). Our objective was to evaluate the temporal trends of the total mortality burden of NF associated with S. aureus in the U.S.

    Methods: We obtained mortality data from the National Center for Health Statistics (NCHS), which receives information from death certificates from all 50 states, including demographic information and cause of death (primary and contributing). The U.S. Multiple Cause of Death Files were searched from 2003 through 2013 for a listing of NF (ICD10 code M72.6) as either the primary or contributing cause of death. In order to study S. aureus-associated cases of fatal NF, we further selected cases with a diagnosis of S. aureus septicemia (ICD10 A41.0), as results from tissue cultures in NF are not included as an ICD10 diagnosis. We first examined the overall distribution of demographic factors of fatal cases of S. aureus-associated NF, then used a non-parametric extension of the Wilcoxon rank-sum test (nptrend, Stata v13) to examine temporal changes in mortality during the study period.

    Results: We identified a total of 486 deaths caused by S. aureus-associated NF during between 2003 and 2013. Most patients were men (52.5%) and of white, non-Hispanic race/ethnicity (65%). The greatest number of deaths occurred among patients age 55-64 years old, and overall 71% of patients were age 55 or older. In time trend analysis, we observed a non-significant increase in the number of fatal S. aureus-associated NF cases each year (p=0.07), with a significant increase in the number of cases occurring in patients age 55 and older (p=0.04).

    Conclusion: In the U.S. between 2003-2013, fatal cases of S. aureus-associated NF were predominantly observed in older individuals of white, non-Hispanic ethnicity. In future work we will examine co-morbid conditions of these patients, and utilize census data to generate age-adjusted mortality rates.

    Nida Arif, MD, Division of Infectious Disease and HIV Medicine, Drexel University College of Medicine, Philadelphia, PA, Shahrukh Yousfi, MBBS, Drexel University College of Medicine, Philadelphia, PA and Christopher Vinnard, MD, Department of Medicine, Division of Infectious Diseases & HIV Medicine, Drexel University College of Medicine, Philadelphia, PA

    Disclosures:

    N. Arif, None

    S. Yousfi, None

    C. Vinnard, None

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