1163. Epidemiology of recurrent staphylococcal skin and soft tissue infections in children presenting to an outpatient Pediatric infectious disease Clinic in Cleveland, OH   2009-2111
Session: Poster Abstract Session: Staphylococcus aureus Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • IDSA 2011PDF.pdf (348.4 kB)
  • Background: With the emergence of methicillin resistant Staphylococcus aureus (MRSA) as a community-associated pathogen, many children have suffered from recurrent staphylococcal skin and soft tissue infections. These infections are painful and may require multiple incision and drainage procedures resulting in medical, psychological and economic burdens for patients and their families. There are few studies to date that define the clinical epidemiology of recurrent staphylococcal  abscesses in children. Our aim is to define the epidemiology of these infections in children.

    Methods:  Charts of children presenting with recurrent skin and soft tissue infections between 11/2009 and 3/ 2011 to the PIDC  were retrospectively reviewed for clinical and microbiology data.

    Results:  Of 36 children with recurrent abscesses, 57%  were female and  60% were White. The mean age was 6.6 years (range, 8 mo.-19 years); a bimodal age distribution was observed with 50% (18/36) of disease occurring in children ≤ 3 years of age and 39% (14/36) in children older ≥ 8 years of age. The mean number of abscesses was 4.6 (range 2-15). Commonly affected sites included the buttock/groin area (80%), upper thigh (37%), and abdomen (17%). Children ≤ 3 years of age were more likely to have a buttock abscess than children ≥ 8 years of age (p=0.035).  Eighty percent of the children had at least one other close contact with history of abscesses and  in 64% of the children, this contact shared the same house.

    Of 31 patients with cultures, 24 (77% ) had MRSA and 6 (19%) had methicillin susceptible S. aureus (MSSA). Ninety-three % of the isolates were susceptible to clindamycin and 100% were susceptible to trimethoprim/sulfamethoxazole and doxycycline. The most common antibiotics prescribed to treat these infections were trimethoprim/sulfamethoxazole (62%) and clindamycin (14%).  

    Conclusion: Recurrent abscesses in children have a bimodal distribution (≤ 3  and ≥ 8 years) and children ≤ 3 years were more likely to have a buttock abscess.   Commonly there is another household member with an abscess. Based on our observations decolonization strategies may need to target families in addition to the individual patient.


    Subject Category: P. Pediatric and perinatal infections

    Blanca Gonzalez, M.D, Pediatrics, University Hospitals Case Medical Center. Case Western Reserve University, Cleveland, OH; Division of Pediatric Infectious Diseases and Rheumatology, Rainbow Babies and Children's Hospital, Cleveland, OH, Frank Esper, MD, Case Western Reserve University, Cleveland, OH; University Hospitals Case Medical Center, Cleveland, OH; Rainbow Babies and Children's Hospital, Cleveland, OH, Ethan Leonard, M.D, Divisions of Pediatric Infectious Diseases & General Academic Pediatrics, Rainbow Babies & Children's Hospital/Case Medical Center, Cleveland, OH and Curtis J. Donskey, MD, Louis Stokes Cleveland VA Medical Center, Cleveland, OH

    Disclosures:

    B. Gonzalez, None

    F. Esper, None

    E. Leonard, None

    C. J. Donskey, None

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