Epidemiology of staphylococcal scalded skin syndrome in US children

BackgroundStaphylococcal scalded skin syndrome (SSSS) is a blistering dermatosis caused by exfoliative toxins released from Staphylococcus aureus. ObjectivesTo describe the incidence, costs, length of stay (LOS), comorbidities and mortality of SSSS in U.S. children. MethodsThe Nationwide Inpatient Sample 2008-2012 was analysed, including a 20% sample of U.S. hospitalizations and 589 cases of SSSS. ResultsThe mean annual incidence of SSSS was 767 (range 183-1188) per million U.S. children, with 451 cases per million U.S. infants age <2years. In multivariable logistic regression models, SSSS was significantly associated with the following (shown as adjusted odds ratio and 95% confidence interval): female sex (112, 100-125), age (2-5years: 1331, 1182-1499; 6-10years: 293, 235-366; 11-17years: 044, 031-063); race/ethnicity (black: 069, 058-084) and season (winter: 204, 166-250; summer: 347, 286-422; autumn: 304, 249-370), with increasing odds over time (2010-2011: 228, 207-251; 2012: 298, 269-330). The geometric mean (95% confidence interval) LOS and cost of hospitalization for patients with vs. without SSSS were 32 (30-34) vs. 24 (24-25) days and $46240 ($4250-$5030) vs. $1872 ($17827-$1965). Crude inpatient mortality rates (with 95% confidence intervals) were similar for children with vs. without SSSS (033%, 000-079% vs. 036%, 034-039%). SSSS was associated with other infections, including in the upper respiratory tract and skin. ConclusionsThe prevalence of SSSS appears to be increasing over time, and was associated with a number of sociodemographic factors and other infections. Further studies are needed to confirm these findings and reduce rising rates of SSSS. What's already known about this topic? Staphylococcal scalded skin syndrome is a rare but potentially life-threatening infection in childhood. What does this study add? Paediatric staphylococcal scalded skin syndrome is associated with prolonged hospitalization, increased costs of care, multiple infectious comorbidities, rising incidence and significant racial/ethnic disparities in the U.S.A. Respond to this article