From 2000 through 2012, health care records of the Military Health System documented 998,671 incident cases of bacterial skin infections among active component members of the U.S. Armed Forces. Most cases (97.3%) were identified from records of outpatient medical encounters rather than hospitalizations. Cellulitis accounted for half (50.9%) of all cases of bacterial skin infection but 96 percent of associated hospital bed days. Of all cases, 42.3 percent were "other" skin infections (i.e., folliculitis, impetigo, pyoderma, pyogenic granuloma, other and unspecified infections). The remainder were attributable to carbuncles/furuncles (6.6%) and erysipelas (0.1%). Rates of infection were higher among female service members except for "other" skin infections. In general, the highest rates were associated with youth, recruit trainee status, and junior enlisted rank; however, rates of erysipelas were highest among those 50 years and older. Annual incidence rates of all bacterial skin infections have increased greatly since 2000. During the entire period, such infections required more than 1.4 million health care encounters and 94,000 hospital bed-days (equivalent to 257 years of lost duty time). The prevention, early diagnosis, and treatment of bacterial skin infections, particularly in high risk settings, deserve continued emphasis.
