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. 2025 Jun 9;25:467. doi: 10.1186/s12887-025-05825-z

Epidemiological trends and disparities in the global burden of bacterial skin diseases among children and adolescents from 1990 to 2021: an analysis based on GBD 2021

Hongen Guo 1, Peixin Zheng 2,✉
PMCID: PMC12147331  PMID: 40490714

Abstract

Background

Bacterial skin diseases (BSDs) represent a substantial public health concern for children and adolescents worldwide. The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has further complicated treatment, efforts, highlighting the urgent need for targeted policies aimed at prevention and management.

Methods

This study utilized data from the Global Burden of Disease (GBD) 2021 database, to analyze the global burden of BSDs among individuals aged 0–19 years from 1990 to 2021. Incidence, prevalence, and disability-adjusted life years (DALYs) were the primary indicators assessed. stratified analysis conducted by gender, age, region, and socio-demographic index (SDI). Temporal trends were evaluated using the estimated annual percentage change (EAPC). Date analysis and visualization were performed using the R programming language.

Results

In 2021, the global incidence of BSDs among children and adolescents reached 338 million cases, an increase of 49.32% compared to 1990 (EAPC = 0.86); Prevalence reached 14.23 million cases, an increase of 48.27% (EAPC = 0.85). During the same period, the DALYs rate decreased by 39.01% (EAPC = -1.9). Regionally, the burden was highest in sub-Saharan Africa, while the highest increase in incidence was observed in high-income North America. SDI-based stratification showed that DALYs were highest among infants in low SDI regions, while high SDI regions experienced a marked increase in incidence among adolescents aged 15–19 years. Gender analysis found that the incidence was higher among girls under five years of age, while the overall burden was higher among boys aged 15–19 years compared to girls. Neonates (0–6 days) were identified as the highest-risk group.

Conclusion

Although a moderate decline in DALYs rate was observed, the incidence and prevalence of BSDs continued to rise globally, with geographic, age-related, and genders disparities. These findings underscore the necessity of developing stratified and targeted intervention strategies to mitigate the increasing burden of BSDs among children and adolescents.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-025-05825-z.

Keywords: Global burden of disease, Children, Adolescents, Bacterial skin diseases

Background

Bacterial skin diseases (BSDs) are infections caused by pathogenic microorganisms that affect the skin and its appendages, primarily including pyoderma and cellulitis [1]. The principal causative pathogens are Streptococcus species are Streptococcus species and Staphylococcus aureus. In recent years, the emergence and dissemination of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) have markedly reduced the efficacy of conventional antibiotics, thereby complicating the treatment of BSDs [2]. Evidence suggests that CA-MRSA infections occur most frequently in children, with abscesses and cellulitis comprising approximately 77% of cases [3]. These infections not only compromise skin integrity but also negatively impact patients’ psychological and social well-being [1, 4]. If not treated promptly, serious complications such as sepsis, septicemia, and nephritis may develop, posing long-term health risks [5].

BSDs are among the most prevalent infectious diseases in children and adolescents. According to the Global Burden of Disease (GBD) 2019 study, dermatological conditions account for approximately 6% of the total disease burden in this population, with BSDs—particularly pyoderma—representing a major contributor [6]. Pyoderma exhibits the highest incidence rates in sub-Saharan Africa and Southeast Asia, affecting an estimated 162 million children globally each year [7]. In addition to health implications, BSDs impose significant economic burdens on families and healthcare systems. Evidence indicates that productivity losses due to acute bacterial skin and skin structure infections (ABSSSIs) in children range from €1,814.39 to €8,224.06 per case [8]. In the United States, cellulitis alone accounts for approximately 14 million cases annually, resulting in 650,000 hospitalizations and $3.7 billion in outpatient costs, with these figures continuing to rise [9].

Although existing studies have examined the burden of BSDs across all age groups, systematic and detailed analyses focusing specifically targeting individuals under 20 years of age remain limited. This gap impedes a comprehensive understanding of the health challenges faced by this population and constrains the development of targeted public health policies and interventions.

This study utilizes the most recent GBD 2021 data to examine the incidence, prevalence, and disability-adjusted life years (DALYs) burden of BSDs among children and adolescents under 20 years of age at global, regional, and national levels from 1990 to 2021. Through a comprehensive analysis of disease patterns and temporal trends in this population, the study aims to identify contributing factors that can inform targeted global and regional health policies. These efforts are intended to reduce BSD-related health risks and enhance the quality of life for children and adolescents.

Methods

Data sources and study population

This study employed the most recent GBD 2021 database, developed by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington [10]. All data are publicly available through the Global Health Data Exchange (GHDx) tool [11]. The GBD 2021 database integrates information from health surveys, systematic reviews, clinical studies, literature sources, and mortality records across multiple countries and regions, offering a comprehensive and robust quantitative assessment of global health. Detailed descriptions of the GBD data sources and methodology have been published in previous studies [12, 13].

According to the definitions provided by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), children refer to individuals aged 0–17 years, and adolescents refer to individuals aged 10–19 years [14, 15]. In this study, individuals aged 0–19 years are collectively referred to as “children and adolescents” as the specific population of interest. Following the GBD classification, this population was further categorized into four age groups: 0–4 years, 5–9 years, 10–14 years, and 15–19 years. Given the substantial disease burden observed in the 0–4 years group, a more detailed stratification was applied to this subgroup, including 0–6 days, 7–27 days, 1–5 months, 6–11 months, 12–23 months, and 2–4 years, to more precisely identify high-risk populations. Focusing on three primary indicators—incidence, prevalence, and DALYs—This study analyzed the burden of BSDs in among populations at global, regional, and national levels from 1990 to 2021, with attention to variations by gender, age, and geographic region.

Definitions

In the GBD disease classification system, which employsa four-tier hierarchical structure, bacterial skin diseases are categorized as a Level 3 condition under “skin and subcutaneous diseases,“This category includes cellulitis (ICD-10: L03) and pyoderma (ICD-10: L08.0) [16].

DALYs serves as a core metric for quantifying disease burden, reflecting the total number of healthy years lost due to disease onset through to death. DALYs are calculated as the sum of years of life lost (YLLs) due to premature mortality, and years lived with disability (YLDs) [17]. Higher DALY values indicate a greater disease burden.

The Socio-demographic Index (SDI) is a composite measure that includes per capita GDP, average years of education, and fertility rate [18]. It is used to assess a region’s level of socioeconomic development and its associated health outcomes, with values ranging from 0 (characterized by high fertility, low education, and low income) to 1 (low fertility, high education, and high income). In the GBD study, 204 countries and territories were classified into five SDI categories: low, low-middle, middle, high-middle, and high [19]. This classification was used to analyze disparities in disease burden across varying levels of socioeconomic development.

Data analysis

The burden and temporal trends of bacterial skin diseases were analyzed using GBD estimates for incidence, prevalence, and DALYs. The 95% uncertainty interval (UI) was derived from 500 draws from the posterior distribution of the model, and is represented by the 2.5th and 97.5th percentiles [20].

To evaluate trends in disease burden over time, the estimated annual percentage change (EAPC) was calculated [21]. EAPC was derived using a linear regression model:

graphic file with name d33e287.gif

Where Y represents the natural logarithm of the burden metric (incidence, prevalence, or DALYs), X is the year, and ε is the random error term. EAPC and its 95% confidence interval (CI) were computed as:

graphic file with name d33e294.gif

Where β is the coefficient of the time variable in the regression model [22]. An EAPC > 0 with a 95% CI excluding 0 indicates an increasing trend; an EAPC < 0 with a 95% CI excluding 0 indicates a decreasing trend.

Data processing, analysis, and visualization were conducted using R software (version 4.4.2), Visualization and pattern recognition were primarily performed using the ggplot2, dplyr, and MetBrewer packages.

Results

Global trends

In 1990, the global number of BSD incidence cases was 226,128,393 (95% UI: 216,143,125–236,261,552), which increased to 337,652,172 (95% UI: 322,626,622 − 353,559,359) by 2021, reflecting a 49.32% rise. The corresponding incidence rate increased from 10,012.00 per 100,000 population (95% UI: 9,569.89-10,460.65) to 12,810.04 per 100,000 population (95% UI: 12,239.99-13,413.53), with an EAPC of 0.86 (95% CI: 0.83–0.89) during this period (Fig. 1A; Table 1, Supplementary Table 1). Similarly, the number of prevalent BSDs cases rose from 9,599,558 (95% UI: 9,247,910-9,973,131) in 1990 to 14,232,944 (95% UI: 13,689,353 − 14,828,435) in 2021, marking a 48.27% increase. The prevalence rate increased from 425.03 per 100,000 population (95% UI: 409.46-441.57) to 539.98 per 100,000 population (95% UI: 519.35-562.57), with an EAPC of 0.85 (95% CI: 0.82–0.87) (Fig. 1B; Table 1, Supplementary Table 1). In contrast, both the absolute number of DALYs and the DALYs rate for BSDs showed declining trends from 1990 to 2021. The number of DALYs decreased by 39.01%, and the DALYs rate exhibited an EAPC of − 1.9 (95% CI: -2.09 - -1.7) (Fig. 1C; Table 1, Supplementary Table 1).

Fig. 1.

Fig. 1

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Trends in the burden of bacterial skin diseases among individuals under 20 years old globally from 1990 to 2021 (A: Incidence cases and rate trends; B: Prevalence cases and rate trends; C: DALYs and DALYs rate trends)

Table 1.

The number of cases and rates of incidence, prevalence, and dalys of bacterial skin diseases among children and adolescents under 20 years old across different age groups globally in 1990 and 2021 (DALYs: Disability-Adjusted life Years)

Age Measure 1990 2021
Number(95%UI) Rate (95%UI)
per 100,000		 Number (95%UI) Rate (95%UI)
per 100,000
0–20 Incidence

226,128,393

(216143125–236261552)

10012.00

(9569.89-10460.65)

337,652,172

(322626622–353559359)

12810.04

(12239.99-13413.53)
Prevalence

9,599,558

(9247910–9973131)

425.03

(409.46-441.57)

14,232,944

(13689353–14828435)

539.98

(519.35-562.57)
DALYs

835,949

(671395–1039163)

37.01

(29.73–46.01)

509,911

(331086–684298)

19.35

(12.56–25.96)
0–5 Incidence

76,260,738

(71993036–80629540)

12301.35

(11612.94-13006.07)

101,867,150

(96409568–107829328)

15477.29

(14648.09-16383.16)
Prevalence

3,256,748

(3104238–3391445)

525.33

(500.73-547.06)

4,340,240

(4134881–4527448)

659.44

(628.24-687.88)
DALYs

679,948

(531077–863957)

109.68

(85.67-139.36)

355,187

(210278–495585)

53.97

(31.95–75.3)
5–9 Incidence

56,367,150

(51490507–61444737)

9659.67

(8823.96-10529.82)

81,960,474

(74932069–89504617)

11929.27

(10906.29-13027.31)
Prevalence

2,413,415

(2236023–2613977)

413.59

(383.19-447.96)

3,487,004

(3223261–3779256)

507.53

(469.14-550.07)
DALYs

51,227

(37181–69799)

8.78

(6.37–11.96)

39,686

(25859–61640)

5.78

(3.76–8.97)
10–14 Incidence

46,561,413

(42249797–51467492)

8691.98

(7887.09-9607.83)

75,283,675

(68490117–83479946)

11293.07

(10273.99-12522.57)
Prevalence

1,979,874

(1821064–2166645)

369.60

(339.95-404.46)

3,190,411

(2919614–3496954)

478.58

(437.96-524.57)
DALYs

47,516

(35753–63120)

8.87

(6.67–11.78)

45,586

(32196–66835)

6.84

(4.83–10.03)
15–19 Incidence

46,939,092

(42234530–51316988)

9036.77

(8131.04-9879.61)

78,540,872

(70529140–86245176)

12587.08

(11303.11-13821.79)
Prevalence

1,949,520

(1774511–2142906)

375.32

(341.63-412.55)

3,215,288

(2909390–3553670)

515.29

(466.26-569.52)
DALYs

57,259

(39693–75589)

11.02

(7.64–14.55)

69,451

(46792–94779)

11.13

(7.50-15.19)
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Regional trends

In 2021, among the 21 GBD-defined regions, the highest incidence rates of BSDs were observed in Eastern Sub-Saharan Africa, Central Sub-Saharan Africa, and Southern Sub-Saharan Africa. These same three regions also had the highest prevalence rates (Fig. 2). From 1990 to 2021, all three regions exhibited increasing trends in both incidence and prevalence, with EAPC greater than 0 (Fig. 3). The highest DALYs rates were recorded in Eastern Sub-Saharan Africa, Central Sub-Saharan Africa, and Oceania (Fig. 2). Over the 32-year period, the most pronounced increases in incidence and prevalence occurred in High-income North America, with EAPCs of 0.21 (95% UI: 0.02–0.41) and 0.25 (95% UI: 0.08–0.42), respectively. Notably, Central Asia showed substantial increases across all three metrics. Conversely, nearly half of the regions experienced declines in DALYs rates, with the most significant reductions observed in East Asia (Fig. 3).

Fig. 2.

Fig. 2

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Incidence, prevalence, and DALYs rate of bacterial skin diseases among individuals under the age of 20 in the 21 GBD regions in 2021

Fig. 3.

Fig. 3

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EAPC of incidence, prevalence, and DALYs rate of bacterial skin diseases among individuals under the age of 20 at the global and regional levels from 1990 to 2021 (EAPC, Estimated Annual Percentage Change)

SDI-level trends

In terms of absolute burden, bacterial skin diseases are most concentrated among children under the age of 5, particularly in terms of DALYs, where this age group accounts for approximately three-quarters of the burden. However, from 1990to 2021), there has been a noticeable shift in burden toward adolescent populations. In high-SDI regions, individuals aged 15–19 years exhibited the highest burden in incident and prevalent cases, with this age group’s contribution declining progressively with decreasing SDI levels. In contrast, the majority of DALYs among children under 5 were concentrated in low-SDI regions, with the burden increasing gradually as SDI levels rose (Fig. 4).

Fig. 4.

Fig. 4

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Distribution of the burden of bacterial skin diseases by age group in different SDI regions in 1990 and 2021

Across all SDI tiers, low-SDI regions consistently exhibited the highest rates of incidence, prevalence, and DALYs for bacterial skin diseases. Children under the age of 5 carried the greatest burden in all five SDI categories. Between 1990 and 2021, middle-, low-middle-, and low-SDI regions experienced increasing incidence and prevalence rates across all age groups. In contrast, DALYs rates declined overall in all SDI tiers (Fig. 5).

Fig. 5.

Fig. 5

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Incidence (A), prevalence (B), and DALYs rate (C) of bacterial skin diseases among individuals under the age of 20 in SDI regions from 1990 to 2021, stratified by age group

National-level trends

In 2021, the countries with the highest incidence rates of BSDs among individuals under 20 years old were Ethiopia, the United Republic of Tanzania, and Djibouti. These countries also ranked highest in prevalence rates. South Sudan, the Central African Republic, and Zambia record the highest DALYs rates. All these nations are classified as low-SDI regions. In contrast, the countries with the lowest incidence rates were Indonesia, Thailand, and Mauritius, while Indonesia, Thailand, and Sri Lanka had the lowest prevalence rates. Greece, Montenegro, and China reported the lowest DALYs rates. Among these, Indonesia is classified as a low-middle SDI region, while the remaining countriesfall under the high-SDI tier (Fig. 6).

Fig. 6.

Fig. 6

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Burden of bacterial skin diseases among individuals under the age of 20 in 204 countries in 2021 (A: Incidence rate; B: Prevalence rate; C: DALYs rate)

Age and sex-specific patterns

Across all metrics, children under 5 years old bore the heaviest burden of bacterial skin diseases. Over the study period (1990–2021), the incidence and prevalence of BSDs increased across all age groups, with significant increases observed. However, the DALYs rate decreased, particularly among children under 5 years old, dropping from 109.68 (95% UI: 85.67-139.36) to 53.97 (95% UI: 31.95–75.3) (Fig. 7). Despite this decline in DALYs for younger children, the 15–19 age group saw an unexpected increase in DALYs rates in 2021 compared to 1990 (Table 1). The analysis of trends in incidence, prevalence, and DALYs rates for BSDs stratified by gender revealed that in children under 5 years old, the burden was higher in females than in males across all indicators. However, due to a faster decline in DALYs among females compared to males, the situation reversed by 2021. Additionally, among adolescents aged 15–19 years, males generally had a higher burden than females. No significant sex-based disparities were observed in the 5–9 and 10–14 age groups over the study period (Fig. 7). Further stratification of the under-5 age group revealed that neonates aged 0–6 days had the highest incidence and DALYs rates, reaching 1068.38 (95% UI: 650.15-1354.66) and 18081.37 (95% UI: 17043.63-19019.72), respectively. Infants aged 6–11 months exhibited the highest prevalence rate, at 770.90 (95% UI: 742.46-799.07) (Fig. 8).

Fig. 7.

Fig. 7

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Trends in incidence, prevalence, and DALYs rate of bacterial skin diseases among different age groups stratified by gender from 1990 to 2021

Fig. 8.

Fig. 8

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The incidence, prevalence, and DALYs rate of bacterial skin diseases among specific age subgroups of children and adolescents under 20 years old in 2021

Discussion

BSDs have become a significant public health challenge. While previous studies have examined prevalence trends and disease burden of BSDs, they have typically focused on the entire population or a single disease. Studies indicate that children and adolescents have the highest incidence [4].

Globally, from 1990 to 2021, the number of incidence and prevalence cases of BSDs increased by 49.32% and 48.27%, respectively, with the EAPC of incidence and prevalence rates being 0.86 and 0.85, respectively. However, the number of DALYs decreased by 39.01%, with an EAPC of the DALYs rate at -1.9. The main factors contributing to this trend include increased accessibility of antibiotics, improved infection management capabilities, and early intervention of severe complications in recent years, which have reduced the mortality rate of severe cases [23, 24], At the same time, accelerated urbanization, population densification, and antibiotic abuse may have increased the risk of infection transmission [25]. Similar trends have been reported in studies on respiratory infections and diarrheal diseases in low-income countries, suggesting that BSDs may face similar challenges to other infectious diseases—namely, the balance between advancements in treatment and the development of pathogen resistance [26]. These results indicate that antimicrobial management programs (such as limiting non-essential antibiotic prescribing) need to be coordinated with community health education (such as wound care training).

In terms of regional distribution, in 2021, the eastern, central, and southern regions of sub-Saharan Africa continued to lead in terms of incidence, prevalence, and DALYs rates, with all three indicators showing significant increases over the past 32 years. This high burden is closely related to the lack of medical resources, shortage of clean water, dense population, and the tropical climate that promotes bacterial proliferation [27]. In contrast, the DALYs rate in East Asia has declined significantly, likely due to the strengthening of primary healthcare systems and neonatal infection prevention programs in countries like China (e.g., the promotion of sterile childbirth techniques) [28]. Central Asia has seen a synchronous increase in all three indicators, which may be associated with inadequate water and sanitation facilities and uneven resource allocation [29]. Meanwhile, high-income North America has seen the largest increase in incidence rate, possibly related to the reduction in children’s outdoor activities during urbanization, decreased skin barrier function, and antibiotic resistance caused by the misuse of antibiotics [23, 30, 31]. There is a need to remain vigilant about the prevalence of MRSA infections among adolescents. Regional interventions need to be designed differentially: in resource-poor areas, low-cost preventive measures (such as skin hygiene education) and topical antibiotics (such as mupirocin) should be promoted, while in high-incidence areas, school-based skin screening programs should be implemented.

The burden of BSDs showed a clear gradient difference according to the SDI. Low SDI countries, such as Ethiopia and South Sudan, bear the highest incidence, prevalence, and DALYs rates. This suggests that regions with poor socio-economic conditions are more susceptible to BSDs due to the lack of adequate sanitation facilities, medical resources, and health education. Over the past 32 years, there has been a trend of shifting disease burden towards the adolescent population. In high SDI regions, the burden among adolescents aged 15–19 is particularly prominent. Globally, DALYs in this age group have also shown an increasing trend, which is in contrast to other age groups. This may be linked to changes in adolescent lifestyles (e.g., frequent social activities), hormonal fluctuations, and the use of cosmetics that disrupt the skin barrier [32–34]. In contrast, low-middle SDI countries, such as Indonesia, have achieved low BSD incidence rates through the strengthening of primary healthcare. This highlights the importance of improving grassroots diagnostic capacity and ensuring the rational use of antibiotics [35]. These contrasts suggest that economic level is not the sole determinant of disease burden, and that policy interventions can effectively bridge resource gaps.

Children under 5 years of age are always the most burdened group, especially newborns aged 0–6 days. This is related to the incomplete development of the children’s immune system, weaker skin barrier functions, and lack of established hygiene habits [36]. Children under the age of 5 account for approximately 75% of the total DALYs burden, which is directly related to malnutrition, insufficient vaccination, and delayed medical care [37]. Particularly, female children have higher incidence and prevalence rates than male children. However, the decline in DALYs among female children is faster (with male children surpassing them in 2021), which may reflect cultural preferences for prioritizing medical care for female children in some areas and more proactive medical care. In contrast, male adolescents aged 15–19 bear a higher burden than their female counterparts, likely due to more frequent outdoor activities, sports-related injuries, greater exposure risks, and delays in seeking medical care [33]. These patterns highlight the need for gender-specific interventions—such aspromoting maternal and infant skin care education and disseminating post-sports skin care guidelines among male adolescents.

The high burden of BSDs among individuals under the age of 20 stems from a combination of biological and social factors. These include the immature immune systems of infants and young children, the dense contact environments in schools or childcare institutions, the risk of antibiotic resistance due to the overuse of antibiotics in healthcare settings, and the unsafe living conditions in low-income areas (such as the lack of clean water). Research indicates that long-term school absences and social stigmatization caused by BSDs can impact children’s cognitive development and mental health. Moreover, the improper use of antibiotics not only reduces the effectiveness of treating infections but can also trigger complications such as gut microbiota dysbiosis through systemic effects, further exacerbating children’s health risks [38]. To address these challenges, comprehensive measures must be implemented to prevent and mitigate the associated risks.

Comprehensive prevention and control require a multi-tiered strategy: at the individual level, promote family-centered preventive education (such as proper wound care); at the community level, establish a screening and referral network anchored by schools; and at the national level, incorporate BSDs into the child health monitoring system, strengthen antibiotic management, and advance medical technology to enhance overall disease prevention and control capabilities. In recent years, significant progress has been made in addressing antibiotic resistance through advancements in medical technology and the effective implementation of national policy measures. For example, new antibiotics such as Dalbavancin and Oritavancin have been discovered, which have strong inhibitory effects on common bacteria like Staphylococcus aureus [39]. The Xpert MRSA/SA system can rapidly detect MRSA infections, significantly reducing diagnostic time [40]. The Infectious Diseases Society of America (IDSA) has released new guidelines for the diagnosis and management of skin and soft tissue infections [41]. Meanwhile the UK’s National Action Plan on Antimicrobial Resistance emphasizes reducing antibiotic use and enhancing resistance monitoring efforts [42].

Limitation of study

However, this study has several limitations. The GBD primarily relies on estimation and mathematical modeling. Due to the influence of confounding factors and differences in data collection and reporting systems across countries, the universality and accuracy of the research may be affected. In addition, the GBD databaseincludes only cellulitis and sepsis among bacterial skin diseases, which may lead to incomplete data when assessing the overall disease burden. Moreover, the study did not consider climatic variables (such as temperature and humidity), which could significantly influence the occurrence and transmission of bacterial skin diseases. Finally, the study did not provide an in-depth analysis of the specific etiology and pathogenesis of these diseases, which to some extent limits the ability to develop targeted intervention strategies.

Future research should focus on an in-depth exploration of the etiology and pathogenesis of bacterial skin diseases, incorporating multidisciplinary approaches to develop more effective prevention and treatment strategies, while also considering environmental factors such as climate. Additionally, it is essential to optimize the global health monitoring system, strengthen international cooperation, and enhance the performance of health systems to more comprehensively assess disease burden and formulate targeted prevention and control measures, These efforts are vital to advancing global public health outcomes.

Conclusion

This study shows that among children and adolescents under the age of 20 globally, the incidence and prevalence of BSDs continued to rise from 1990 to 2021. Although there was a slight decrease in the DALYs rate, the findings suggest a broader spread of the disease whithin the population. Children under five in low SDI regions bear the greatest burden, with higher incidence rates observed among girls under five, particularly neonates (0–6 days) who are at especially high risk. The study highlights the need for a multi-level and more targeted prevention and control strategy, including family based care education, community screening networks, national antibiotic management, and international cooperation to combat antibiotic resistance.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1 (19KB, docx)

Abbreviations

BSDs

Bacterial Skin Diseases

CA-MRSA

Community-Associated Methicillin-Resistant Staphylococcus Aureus

GBD

Global Burden of Disease

DALYs

Disability-Adjusted Life Years

YLLs

Years of Life Lost

YLDs

Years Lived with Disability

SDI

Socio-demographic Index

EAPC

Estimated Annual Percentage Change

ABSSSIs

Acute Bacterial Skin and Skin Structure Infections

UI

Uncertainty Interval

CI

Confidence Interval

IHME

Institute for Health Metrics and Evaluation

GHDx

Global Health Data Exchange

ICD-10

International Classification of Diseases, Tenth Revision

IDSA

Infectious Diseases Society of America

Author contributions

PZ conceived and designed the study and contributed to data collection and quality control. HG analyzed the data and wrote the manuscript. All authors have read and approved this manuscript.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Data availability

The data used in this study are freely available from the Global Health Data Exchange (GHDx) website (http://ghdx.healthdata.org/gbd-results-tool). The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

Declarations

Ethics approval and consent to participate

This study utilized publicly available data from the Global Burden of Disease (GBD) 2021 study, which does not require specific ethics approval or individual consent, as all data were de-identified and aggregated. No additional ethical approval or consent to participate was necessary. As this study is based on publicly available secondary data from the GBD database, it does not meet the definition of a clinical trial and is exempt from trial registration requirements.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Footnotes

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

Supplementary Material 1 (19KB, docx)

Data Availability Statement

The data used in this study are freely available from the Global Health Data Exchange (GHDx) website (http://ghdx.healthdata.org/gbd-results-tool). The datasets analyzed during the current study are available from the corresponding author upon reasonable request.

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