title: 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.
authors.affiliation: University College London Centre for Infectious Disease Epidemiology, London, UK. a.hayward@pcps.ucl.ac.uk
authors.forename: Andrew
authors.initials: A
authors.lastname: Hayward
authors.forename: Felicity
authors.initials: F
authors.lastname: Knott
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
authors.forename: David M
authors.initials: DM
authors.lastname: Livermore
authors.forename: Georgia
authors.initials: G
authors.lastname: Duckworth
authors.forename: Amir
authors.initials: A
authors.lastname: Islam
authors.forename: Anne M
authors.initials: AM
authors.lastname: Johnson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004739:England / Q000453:epidemiology; D005194:Family Practice; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends*; D006801:Humans; D011023:Pneumonia, Staphylococcal / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data / Q000639:trends*; D018805:Sepsis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents