title: Staphylococcus aureus skin and soft tissue infections in primary healthcare in Denmark: a 12-year population-based study.
abstract: A rise in community-onset Staphylococcus aureus infections has been observed in European countries. To ascertain secular trends of S. aureus infections in primary healthcare in Denmark, we conducted this register-based study in the North Denmark region, during the period 1997-2008. We identified all skin and mucosa specimens obtained by general practitioners and all prescriptions for the preferred oral anti-staphylococcal antibiotic, dicloxacillin. Repeat observations within a 12-month period were excluded prior to the calculation of age and gender standardised incidence rates per 100,000 person-years. We included 108,758 specimens, of which 42,778 (39%) yielded S. aureus. The annual incidence rate of specimens doubled during the study period, reaching 2,399 in 2008. The overall rate of S. aureus isolates increased 2-fold to a stable rate at about 850, but for isolates from children and for impetigo specimens, the increase was steeper, with a peak in 2002. A total of 156,462 dicloxacillin prescriptions had been redeemed and the annual prescription rate increased 2.5-fold, peaking at 3,714 in 2007. In conclusion, the annual rates of specimens, S. aureus infections and dicloxacillin prescriptions more than doubled in primary healthcare during the 12-year study period. A major impetigo epidemic and calls for antibiotic stewardship with increased utilisation of specimens were contributing factors.
authors.affiliation: Department of Clinical Microbiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark. midp@rn.dk
authors.forename: M
authors.initials: M
authors.lastname: Dalager-Pedersen
authors.forename: M
authors.initials: M
authors.lastname: Søgaard
authors.forename: H C
authors.initials: HC
authors.lastname: Schønheyder
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007169:Impetigo / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055656:Prescriptions / Q000706:statistics & numerical data; D011320:Primary Health Care; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents