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Pyomyositis in the United States 2002-2014
Rheanne Maravelas1, Thomas A Melgar1, Duncan Vos2
1Departments of Pediatrics, Adolescent and Internal Medicine, Western Michigan University Homer Stryker School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
Objectives:
Primary pyomyositis is a bacterial infection of skeletal muscle first recognized in tropical regions of the world but needing characterization in temperate climates.
Methods:
This population-based study used the Healthcare Utilization Project/Nationwide Inpatient Sample database to characterize the trends of pyomyositis admissions in the United States from 2002-2014 using ICD-9 diagnostic codes.
Results:
We found a concerning more than three-fold increase in the incident pyomyositis admissions over our study period. The median length of stay was over twice as long compared to other hospitalized patients. Patients with pyomyositis were younger and more likely to be male and Black. There were more cases in the West and South compared to Midwest and Northeast. Age-adjusted odds ratios revealed significant association of pyomyositis with HIV, types 1 and 2 diabetes mellitus, hematologic malignancy, organ transplant, malnutrition, chronic kidney disease, obesity, and rheumatoid arthritis. The most commonly identified bacterial diagnosis was Staphylococcus aureus. Pseudomonas species were the most commonly identified gram-negative bacteria.
Conclusion:
This nationwide review of pyomyositis in the United States suggests a concerning increase in incidence and provides information on the trends, demographics, risk factors, and causative organisms for pyomyositis in the United States.
Insights
Pyomyositis admissions in the US more than tripled from 2002-2014. This bacterial muscle infection disproportionately affects younger males, particularly Black individuals, and is linked to several chronic health conditions.
Area of Science:
- Infectious Diseases
- Epidemiology
- Public Health
Background:
- Primary pyomyositis, a bacterial skeletal muscle infection, was historically recognized in tropical areas.
- Characterization of pyomyositis in temperate climates like the United States is needed.
Purpose of the Study:
- To characterize trends in pyomyositis admissions in the United States from 2002 to 2014.
- To identify demographic factors, risk factors, and common causative organisms associated with pyomyositis.
Main Methods:
- Population-based study utilizing the Healthcare Utilization Project/Nationwide Inpatient Sample database.
- Analysis of pyomyositis admissions using ICD-9 diagnostic codes between 2002 and 2014.
Main Results:
- A more than threefold increase in incident pyomyositis admissions was observed.
- Patients with pyomyositis were younger, more likely male and Black, with higher rates in the West and South.
- Significant associations were found with HIV, diabetes mellitus, hematologic malignancy, organ transplant, malnutrition, chronic kidney disease, obesity, and rheumatoid arthritis. Staphylococcus aureus was the most common pathogen.
Conclusions:
- Pyomyositis incidence in the US has concerningly increased.
- The study provides crucial data on pyomyositis trends, demographics, risk factors, and pathogens in the US.
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