Faculty Collaboration Database

Increased isolation of methicillin-resistant Staphylococcus aureus in pediatric head and neck abscesses. Arch Otolaryngol Head Neck Surg 2006 Nov;132(11):1176-81

Date

11/23/2006

Pubmed ID

17116811

DOI

10.1001/archotol.132.11.1176

Scopus ID

2-s2.0-33751263426 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

OBJECTIVE: To compare the proportion of community-associated, methicillin-resistant Staphylococcus aureus (MRSA) infections in pediatric head and neck abscesses between 2 study periods.

DESIGN: Retrospective case review.

SETTING: Tertiary care pediatric otolaryngology practice. Patients Pediatric patients with head and neck abscesses presenting over 2 separate 2.5-year intervals: July 1999 through December 2001 and January 2002 through June 2004.

INTERVENTIONS: Incision and drainage of abscess.

MAIN OUTCOME MEASURES: Type and antimicrobial susceptibility of cultured organisms.

RESULTS: We identified 21 abscesses in 19 patients from July 1999 through December 2001 and 32 abscesses in 32 patients from January 2002 through June 2004. Of the 21 abscesses in the first study period, 15 demonstrated pathogen growth compared with 29 of 32 abscesses in the second study period. In the first period, 6 (40%) of 15 abscesses yielded S aureus compared with 17 (58.6%) of 29 abscesses in the second period. The proportion of abscesses yielding MRSA increased from 0% (0/6) in the first study period to 64.7% (11/17) in the second study period (P<.01). All MRSA infections were considered to be community acquired.

CONCLUSIONS: Our study demonstrates a statistically significant rise in the proportion of community-associated MRSA infections of the head and neck in the pediatric population at our institution. For communities where similar microbial recovery patterns exist, we suggest that a culture be obtained as soon as possible in a child presenting with a head and neck abscess to identify the organism. Until that time, the best empirical treatment is clindamycin, with other agents available if warranted by culture and sensitivity results. A treatment algorithm is presented.

Author List

Ossowski K, Chun RH, Suskind D, Baroody FM

Author

Robert H. Chun MD Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abscess
Child
Child, Preschool
Female
Head
Humans
Infant
Male
Methicillin Resistance
Neck
Staphylococcal Infections
Staphylococcus aureus