Needle aspiration for the etiologic diagnosis of children with cellulitis in the era of community-acquired methicillin-resistant Staphylococcus aureus.
OBJECTIVE
Cellulitis is a common problem in children but determining the causative agent is difficult. One tool used to identify the etiology is needle aspiration. The purpose of this study was to determine the utility of needle aspiration in pediatric patients with cellulitis in the era of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA).


METHODS
This was a prospective descriptive study conducted in the emergency department of a tertiary care children's hospital. A convenience sample of healthy children, 0 to 18 years old, with cellulitis were enrolled. A standard cellulitis aspiration technique was performed.


RESULTS
Twenty patients were enrolled and had cultures obtained. The etiologic agent was determined in 15% (3/20) of patients. The positive cultures were all MRSA.


CONCLUSIONS
Although needle aspiration of cellulitis was of low yield, the only pathogens isolated in this study were CA-MRSA. Empiric antibiotics for cellulitis should include coverage for MRSA. In circumstances in which bacterial etiology and antibiotic susceptibility knowledge would be critical, needle aspiration should be considered.
Baylor College of Medicine, Houston, TX, USA. falgun.wylie@gmail.com
Falgun
F
Patel Wylie
Sheldon L
SL
Kaplan
Edward O
EO
Mason
Coburn H
CH
Allen
D000293:Adolescent; D001707:Biopsy, Needle / Q000379:methods; D002481:Cellulitis / Q000175:diagnosis / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000382:microbiology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis*