A hidden epidemic of impetigo trends from the THIN database of primary care consultations

L.J.F. Shallcross*, A.C. Hayward, A.M. Johnson, I. Petersen

Author address: 

(London, UK)


Objectives: Outbreaks of impetigo have been described in Northern Europe but information on the incidence and natural history of disease in the general population is limited. Impetigo is primarily a disease of childhood caused by infection with either staphylococci or Group A streptococci. To investigate the burden of disease in primary care we examine time trends in the incidence of impetigo over the past two decades using data from the Health Improvement Network (THIN) primary care database.coagulase-negative Staphylococcus spp. while culture indicated Staphylococcus aureus and in the other case, PCR indicated Enterococcus faecalis while culture indicated mixed coliforms. The predominant bacterial species detected were coagulase-negative Staphylococcus spp. (4/9), Proteus mirabilis (3/9) and Enterococcus faecalis (3/9). In addition, the fungi Candida albicans (2/9), C. glabrata (1/9) and Aspergillus fumigatus (3/9) were detected. Anaerobes detected by culture in one sample were not detected by PCR due to kit limitations. Of the patients with suspected sepsis, all were found to be negative by both PCR and 48 hour blood culture. The time from the start of sample processing to final report was between 57 hour for PCR as compared to conventional blood/swab culture which was 2448 hour. Conclusions: The agreement between the PCR and the standard wound swab cultures was generally good. Despite the identification profile of the PCR technique being limited to 25 bacterial and fungal species, more organisms were identified in skin/soft tissue samples by PCR than by culture. The multiplex PCR and blood culture results agreed fully, with the added benefit that the PCR results were available within a few hours of sampling. This multiplex PCR technique is a more rapid approach to identification of sepsis than blood culture although some development is required to extend its use for the diagnosis of other infection

abstract No: 


Full conference title: 

22nd European Congress of Clinical Microbiology and Infectious Diseases
    • ECCMID 22nd (2012)