Epidemiology

Impetigo is the most common bacterial skin infection in children worldwide, with a global prevalence of over 162 million.[2][3]​​​ Median childhood prevalence is 12.3%.[2]​ Around 10% of children presenting to US medical clinics with skin complaints are diagnosed with impetigo.[4][5]​​​ Impetigo is diagnosed most frequently in black children.[6]​ The annual incidence of impetigo in the UK is approximately 80/100,000 in children aged 0 to 4 years, decreasing to approximately 50/100,000 in those aged 5 to 14 years. It decreases further in older age groups.[7]

Bullous impetigo can occur at any age. Nonbullous impetigo also occurs in all age groups, but is a particular concern in newborns, in whom it is potentially more serious due to increased risk of sepsis and other life-threatening infections (e.g., pneumonia).[8]​ In the US and Europe, Staphylococcus aureus is the usual causative agent. PCDS Clinical Guidance: impetigo Opens in new window In hot and humid areas of the world, the streptococcal form predominates and is often endemic.[9][10]​​​ The incidence of impetigo is higher in summer months, due to environmental factors such as increased humidity.[9][11]​​​

Impetigo is typically found in conditions of overcrowding, poor hygiene, malnutrition, and where the skin barrier is defective (e.g., due to insect bites and scabies​​​​​).[1][7][9][12][13]​ It is highly infectious through fomites.

The nasal carriage of Staphylococcus aureus can be as high as approximately 40% for bullous impetigo, and approximately 60% for the nonbullous form.[9][14]​​​ MRSA can be a causative organism and is seen more often in cases of nonbullous impetigo.[15]

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