Prevalence, Comorbidities, and Mortality of Staphylococcal Scalded Skin Syndrome in United States Children

Purpose: Staphylococcal Scalded Skin Syndrome is an illness caused by exfoliative toxins released from Staphylococcus aureus. SSSS is characterized by erythema, blistering, and scalding of the skin. This study aimed to look at predictors of SSSS and its related morbidity since they are both poorly defined. Methods: Data on 6,149,864 hospitalizations from the 2008-2012 Nationwide Inpatient Sample, a 20% stratified sample of US hospitalizations, was analyzed. ICD-9-CM coding was used to identify 589 hospitalizations with a diagnosis of SSSS. Prevalence, length of stay, costs of care, and comorbidities due to SSSS were determined. Results: The annual incidence of SSSS was 7.67 (range: 1.83–11.88) per-million US children, with 45.1 cases per-million US infants age 0-1 years. In multivariate survey logistic regression models, SSSS was significantly associated with female sex (adjusted odds ratio [95% confidence interval]: 1.12 [1.00–1.25], age (2-5: 13.31 [11.82-14.99], 6-10: 2.93 [2.35–3.66], 11-17: 0.44 [0.31–0.63] compared to 0-1 years), race/ethnicity (black: 0.69 [0.58–0.84] compared to white), season (winter: 2.04 [1.66–2.50], summer: 3.47 [2.86–4.22], fall: 3.04 [2.49–3.70] compared to spring), year (2010-2011: 2.28 [2.07–2.51], 2012: 2.98 [2.69–3.30] compared to 2008-2009), among other socio-demographic factors. Conclusion: Significant age, race, socioeconomic, and comorbid disparities exist in the incidence of SSSS in US children.