The increased risk of community-acquired methicillin-resistant Staphylococcus aureus neck abscesses in young children.
OBJECTIVE
To analyze the microbiological origins of deep neck space infections requiring surgical intervention in a pediatric population.


METHODS
Retrospective cohort study.


METHODS
The study population (N = 136) included all pediatric patients surgically treated for deep neck space abscesses in a metropolitan tertiary care children's hospital over the course of 5 years (September 2004-August 2009). Demographic and clinical information was compared with microbiological isolate data.


RESULTS
Microbiological analysis of 118 bacterial isolates demonstrated 49 (42%) methicillin-resistant Staphylococcus aureus (MRSA), 35 (30%) methicillin-sensitive S. aureus, and 34 (28%) non-S. aureus (N-SA) isolates. The median age was 16 months (range, 1 month-13years). Patients <16 months of age were 10 times more likely to have an S. aureus (SA) infection versus N-SA (P <.0001). MRSA comprised the majority of all SA isolates (58%). Eighty percent of all SA abscesses were located in the lateral neck. African American pediatric patients accounted for 70% of all deep neck space infections, and 86% of all MRSA infections. Clindamycin resistance was noted in 8% (4/49) of all community-acquired MRSA isolates.


CONCLUSIONS
Children younger than 16 months and/or with lateral neck abscesses are at a significantly increased risk of having an SA infection, the majority being MRSA.
Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Praveen
P
Duggal
Iman
I
Naseri
Steven E
SE
Sobol
D000038:Abscess / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology / Q000628:therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D009333:Neck; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology* / Q000473:pathology / Q000628:therapy
D000900:Anti-Bacterial Agents