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

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.

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.

Figure 2

Crude general practitioner (GP) prescription rates (per 100 population), England, 1991–2006.