title: Self-reported incidence of skin and soft tissue infections among deployed US military.
abstract: The incidence of skin and soft tissue infections has steadily increased over the past decade, and military populations, particularly recruits, have been affected. However, the epidemiology of skin and soft tissue infections in deployed personnel has not previously been described. We conducted a cross-sectional study of United States military personnel in mid-deployment using self-reported questionnaire data containing 11 demographic questions and 20 questions related to skin and soft tissue infections. The primary outcome was self-reported incident SSTI. Descriptive analyses were conducted and incidence estimates calculated. Multivariable regression models were developed to evaluate the association between SSTI and important covariates. Self-reported treatment modalities and effect on work performance were also assessed. The study was approved by the Institutional Review Board. 2125 questionnaires were completed over 12 months using convenience sampling. 110 personnel (5%) reported one or more skin and soft tissue infection during their most recent employment, for an incidence of 52 cases per 100,000 person-days. The majority reported a single infection. A higher proportion of individuals reporting skin and soft tissue infection were female, reported antibiotic use in the 6 months prior to completing the survey, had a family member in the healthcare occupation, and were senior enlisted or officers. 40 (36%) were treated with antibiotics and 24 (22%) underwent incision and drainage. Less than 5% (3 patients) required admission. Eighty eight respondents (81%), reported no days of lost job performance. There is a higher than expected incidence of skin and soft tissue infections in deployed military personnel. Although fewer than 20% of patients report missing at least one day of work, this can have a significant impact on the military mission. Further study should be conducted into how to prevent skin and soft tissue infections in military populations.
authors.affiliation: Department of Emergency Medicine, The George Washington University, 2150 Pennsylvania Avenue, NW, Suite 2B, Washington, DC 20037, USA. larissa.may@gmail.com
authors.forename: Larissa
authors.initials: L
authors.lastname: May
authors.forename: Chad
authors.initials: C
authors.lastname: Porter
authors.forename: David
authors.initials: D
authors.lastname: Tribble
authors.forename: Adam
authors.initials: A
authors.lastname: Armstrong
authors.forename: Manal
authors.initials: M
authors.lastname: Mostafa
authors.forename: Mark
authors.initials: M
authors.lastname: Riddle
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D012307:Risk Factors; D057566:Self Report; D012874:Skin Diseases, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult