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


METHODS
Retrospective case review.


METHODS
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.


METHODS
Incision and drainage of abscess.


METHODS
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.
Ossowski
Kathryn
K
Section of Otolaryngology-Head and Neck Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.
Chun
Robert H
RH
Suskind
Dana
D
Baroody
Fuad M
FM
D000038:Abscess / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006257:Head; D006801:Humans; D007223:Infant; D008297:Male; D016106:Methicillin Resistance; D009333:Neck; D013203:Staphylococcal Infections / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*