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. 2024 May 7;11(6):ofae267.
doi: 10.1093/ofid/ofae267. eCollection 2024 Jun.

The Incidence of Skin and Soft Tissue Infections in the United States and Associated Healthcare Utilization Between 2010 and 2020

Venanzio Vella  1 , Dominique Derreumaux  2 , Emmanuel Aris  2 , Michele Pellegrini  3 , Mario Contorni  4 , Michael Scherbakov  5 , Fabio Bagnoli  6
Affiliations

The Incidence of Skin and Soft Tissue Infections in the United States and Associated Healthcare Utilization Between 2010 and 2020

Venanzio Vella et al. Open Forum Infect Dis. .

Abstract

Background: The number of patients with skin and soft tissue infections (SSTIs) in the United States appeared to be increasing well into the 21st century. However, no recent data have confirmed this trend.

Methods: This retrospective, observational cohort study used claims data over 11 years (2010-2020) from Optum's de-identified Clinformatics Data Mart Database. SSTI episodes, complications, and comorbidities were identified using International Classification of Diseases codes. Annual SSTI incidence rates, proportions of recurrent SSTI, SSTI-associated deaths, and total costs were estimated.

Results: During the study period, 5.4 million patients experienced 9.1 million SSTI episodes, with an incidence of 77.5 (95% confidence interval, 77.4-77.5) per 1000 person-years of observation (PYO). Annual incidence did not change significantly over time. Overall incidence (per 1000 PYO) of SSTI episodes in patients without comorbidities was 32.1 (highest incidence was for previous SSTI [113.5]) versus much higher rates if comorbidities were present. Incidence rates (per 1000 PYO) of chronic ulcers increased over time from 11.3 to 18.2 (P < .0001) and complicated disease from 3.5 to 6.3 (P < .0001). Deaths occurring within 30 days post-SSTI hospitalization rose from 2.6% to 4.6% in 2020. Recurrences occurred in 26.3% of index cases. The mean cost of an SSTI episode was US$3334 (median US$190) and was highest for surgical site infections and chronic ulcers.

Conclusions: The epidemiology of SSTI in the United States is changing and the disease burden is increasing despite stabilization in overall incidence. These data can inform identification of priority populations who could benefit from targeted interventions.

Keywords: chronic ulcer; epidemiology; healthcare costs; incidence; skin and soft tissue infections.

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Conflict of interest statement

Potential conflicts of interest. E. A., M. P., F. B., V. V., and M. S. are employed by and hold financial equities in GSK. D. D. is employed by GSK. M. C. was employed by GSK at the time of the study. These authors declare no other financial and non-financial relationships and activities.

Figures

Figure 1.
Figure 1.
Incidence rates of skin and soft tissue infection (SSTI) and hospitalizations for SSTI per 1000 person-years of observation by demographic and socioeconomic factors. Abbreviations: CCI, Charlson Comorbidity Index; SSTI, skin and soft tissue infection.
Figure 2.
Figure 2.
Indirect comparison of the annual incidence rates of skin and soft tissue infection (SSTI) between our study (Optum) and selected previous reports [1–3]. A, Any. B, By type of SSTI. C, Hospitalized SSTI. D, SSTI with complications. Other includes folliculitis, impetigo, furuncle, mastitis, and other. Abbreviations: PYO, person-years of observation; SSI, surgical site infection and infection due to device or graft; SSTI, skin and soft tissue infection.
Figure 3.
Figure 3.
Percentage of index skin and soft tissue infections (SSTIs) with recurrence and incidence of recurrent SSTI. Abbreviation: PYO, person-years of observation.
Figure 4.
Figure 4.
Percentage of skin and soft tissue infection (SSTI) episodes ending in death during or within 30 d after hospitalization. The total length of bars is related to the mortality that occurred between admission up to 30 days after discharge.
See this image and copyright information in PMC

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