Decolonization of children after incision and drainage for MRSA abscess: a retrospective cohort study.
OBJECTIVE
Whether decolonization following incision and drainage (I&D) for methicillin-resistant Staphylococcus aureus (MRSA) abscess decreases repeat I&D and MRSA-positive cultures in children is unknown.


METHODS
Referral to the Pediatric Infectious Disease Service (PIDS) for decolonization was determined for eligible children (2003-2010), with outcomes studied over 12 months.


RESULTS
We identified 653 children; 54 had been seen by PIDS. In the PIDS group, no patients (0/54, 0%) had a repeat I&D. In the no PIDS group 36/599 (6%) had a repeat I&D, P = .06. Logistic regression modeling for repeat I&D showed no significant effect, odds ratio = 0.29; 95% confidence interval = 0.04-2.15; P = .23. In the PIDS group, 3 patients (3/54, 5.6%) had a repeat MRSA-positive culture. In the no PIDS group, 58/599 (9.7%) had a positive repeat culture, P = .46. Logistic regression modeling for positive culture showed no significant effect (odds ratio = 0.55; 95% confidence interval = 0.17-1.81; P = .32).


CONCLUSIONS
We detected no statistically significant association between decolonization and repeat I&D or MRSA-positive culture.
Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN Division of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN Ryan White Center for Pediatric Infectious Disease, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN Regenstrief Institute for Healthcare, Indianapolis, IN sfinnell@iu.edu.
S Maria E
SM
Finnell
Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN Regenstrief Institute for Healthcare, Indianapolis, IN.
Marc B
MB
Rosenman
Ryan White Center for Pediatric Infectious Disease, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
John C
JC
Christenson
Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN Regenstrief Institute for Healthcare, Indianapolis, IN.
Stephen M
SM
Downs
D000038:Abscess / Q000601:surgery*; D000281:Administration, Intranasal; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001494:Baths / Q000379:methods; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004202:Disinfectants / Q000008:administration & dosage; D004322:Drainage; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D016712:Mupirocin / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors; D012973:Sodium Hypochlorite / Q000008:administration & dosage*; D013203:Staphylococcal Infections / Q000628:therapy*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004202:Disinfectants; D016712:Mupirocin; D012973:Sodium Hypochlorite
MRSA; abscess; bleach; decolonization; incision and drainage procedure; mupirocin