Skin infections on the rise

A new paper in the American Journal of Emergency Medicine uses data from the National Hospital Ambulatory Medical Care Survey to estimate emergency department visits nationally for cutaneous abscesses. The number of visits more than doubled over the 10-year period from 1996 through 2005 with 3.3 million visits occurring in 2005. Only 12% of these patients required hospital admission. If we consider that the most common cause of cutaneous abscesses is MRSA, that the incidence has likely increased in the period since 2005, and given that only a fraction of such infections are seen in the ED setting, we can surmise that the burden of disease due to MRSA in the community is high. Moreover, there are additional persons in the community who are colonized but not infected, and the patients captured in this study likely don’t represent those colonized or infected with the classic hospital acquired strains, which are much less likely to cause cutaneous abscesses. So for those of us who work in hospitals, this paper is a reminder that the sources of MRSA in the inpatient setting are increasingly likely to be visitors and healthcare workers who are colonized or have minor infections.