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Epidemiological of cat scratch disease among inpatients in the Spanish health system (1997–2015)

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Abstract

Cat scratch disease, whose causative agent is Bartonella henselae, is an anthropozoonosis with a worldwide distribution that causes significant public health problems. Although it is an endemic disease in Spain, the available data are very limited. The aim of our study was to describe cat scratch disease inpatients in the National Health System (NHS) of Spain. This was a retrospective descriptive study using the minimum basic data set (CMBD in Spanish) in patients admitted to hospitals of the NHS between 1997 and 2015 with a diagnosis of cat scratch disease (ICD-9: 078.3). We found 781 hospitalized patients diagnosed with cat scratch disease. The mean age (± SD) was 30.7 ± 25.3 years old. The male/female ratio was 1.1:1. The incidence rate over the study period was 0.93 (95% CI, 0.86–0.99) cases per million person-years. The incidence rate in men was 0.98 cases per million person-years and that in women was 0.88 cases per million person-years. The cases were more frequent from September to January. A total of 652 (83.5%) cases were urgent hospital admissions. The average hospital stay was 8.4 ± 8.9 days. The overall lethality rate of the cohort was 1.3%. We have demonstrated that CSD causes a substantial burden of disease in Spain, affecting both adult and pediatric patients with a stable incidence rate. Our data suggest that CSD is benign and self-limited, with low mortality, and its incidence is possibly underestimated. Finally, there is a need for a common national strategy for data collection, monitoring, and reporting, which would facilitate a more accurate picture and the design of more strategic control measures. Hospital discharge records (HDRs) could be a good database for the epidemiological analysis of the hospital management of CSD.

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Author information

Author notes

  1. Beatriz Rodríguez Alonso and Montserrat Alonso-Sardón have contributed equally as first authors of this manuscript.

  2. José Luis Pérez Arellano and Moncef Belhassen-García have contributed equally as senior authors of this manuscript.

Authors and Affiliations

  1. Servicio de Medicina Interna, Complejo Asistencial Universitario de Salamanca (CAUSA), Salamanca, Spain

    Beatriz Rodríguez Alonso

  2. Area of Preventive Medicine and Public Health, Instituto de Investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Salamanca, Spain

    Montserrat Alonso-Sardón

  3. Servicio de Medicina Interna, Unidade Local de Saúde da Guarda, Guarda, Portugal

    Hugo Miguel Rodrigues Almeida

  4. Servicio de Medicina Interna, CAUSA, IBSAL, CIETUS, Salamanca, Spain

    Ángela Romero-Alegria

  5. Servicio de Medicina Interna, Hospital Marques de Valdecilla, CIETUS, Avenida Valdecilla S/N, Santander, Spain

    Javier Pardo-Lledias

  6. Servicio de Dermatología, CAUSA, CIETUS, IBSAL, Salamanca, Spain

    Virgínia Velasco-Tirado

  7. Servicio de Medicina Interna, Infectious Diseases Section, CAUSA, Instituto de Investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), University of Salamanca, Salamanca, Spain

    Amparo López-Bernus

  8. Infectious Diseases and Tropical Medicine Unit, Complejo Hospitalario Universitario Insular-Materno Infantil de Gran Canaria, Las Palmas de Gran Canaria, Spain

    José Luis Pérez Arellano

  9. Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Complejo Asistencial Universitario de Salamanca (CAUSA), Instituto de Investigación Biomédica de Salamanca (IBSAL), Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Universidad de Salamanca, Paseo San Vicente 58-182, 37007, Salamanca, Spain

    Moncef Belhassen-García

Authors
  1. Beatriz Rodríguez Alonso
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  2. Montserrat Alonso-Sardón
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  3. Hugo Miguel Rodrigues Almeida
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  4. Ángela Romero-Alegria
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  5. Javier Pardo-Lledias
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  6. Virgínia Velasco-Tirado
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  7. Amparo López-Bernus
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  8. José Luis Pérez Arellano
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  9. Moncef Belhassen-García
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Contributions

Study design: MBG, BRA, and JLPA

Data collection: VVT, MAS, ALB, and ARA

Data analysis: MAS and HMRA

Writing: MBG, JLPA, JPLL, and BRA

Corresponding author

Correspondence to Moncef Belhassen-García.

Ethics declarations

This study is based on medical data of patients collected in the CMBD. These data are the responsibility of the Ministry of Social Services of Health and Equality (Ministerio de Servicios Sociales, Sanidad e Igualdad, MSSSI) that compiles and organizes them. All patient data provided by the CMBD are anonymized and deidentified by the MSSSI before they are provided to the applicants. According to this confidentiality commitment signed with the MSSSI, researchers cannot provide the data to other researchers, so other researchers must request the data directly from the MSSSI.

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study protocol was approved by the Clinical Research Ethics Committee of the Complejo Asistencial Universitario de Salamanca (CAUSA). Because it is an epidemiological study, written consent was not obtained. All data analyzed were anonymized.

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Rodríguez Alonso, B., Alonso-Sardón, M., Rodrigues Almeida, H.M. et al. Epidemiological of cat scratch disease among inpatients in the Spanish health system (1997–2015). Eur J Clin Microbiol Infect Dis 40, 849–857 (2021). https://doi.org/10.1007/s10096-020-04087-0

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  • DOI: https://doi.org/10.1007/s10096-020-04087-0

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