title: Suppurative cervical lymphadenitis in infancy: microbiology and sociology.
abstract: OBJECTIVE
  To investigate the associations between patient age, sociological factors, and the microbiology of pediatric neck infections.
  
  
  METHODS
  Retrospective chart review of children up to 5 years old who underwent surgical management of suppurative cervical lymphadenitis.
  
  
  RESULTS
  A total of 76 individuals met inclusion criteria; 93% of culture-positive infections were caused by Staphylococcus aureus in infants, compared with 59% in children between 13 months and 5 years of age (P = .002). Of the S aureus isolates, 51% were methicillin-resistant S aureus (MRSA) and 49% were methicillin-sensitive S aureus. Methicillin resistance was associated with African American race (P = .004); 67% of participants received empirical antibiotics prior to admission. Of these, 73% received antibiotics in the β-lactam class, and 25% received treatment with clindamycin.
  
  
  CONCLUSIONS
  Incidence of MRSA is high in infants with cervical lymphadenitis who fail empirical antibiotic therapy and require surgical management. Empirical coverage for cervical lymphadenitis with β-lactam antibiotics may provide inadequate coverage for early infection in this population.
authors.affiliation: Wake Forest™ School of Medicine, Winston-Salem, NC, USA.
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Worley
authors.affiliation: Wake Forest™ School of Medicine, Winston-Salem, NC, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Seif
authors.affiliation: Wake Forest™ School of Medicine, Winston-Salem, NC, USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Whigham
authors.affiliation: Wake Forest™ School of Medicine, Winston-Salem, NC, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Mims
authors.affiliation: Wake Forest™ School of Medicine, Winston-Salem, NC, USA.
authors.forename: Avinash K
authors.initials: AK
authors.lastname: Shetty
authors.affiliation: Wake Forest™ School of Medicine, Winston-Salem, NC, USA akevans@wakehealth.edu.
authors.forename: Adele K
authors.initials: AK
authors.lastname: Evans
mesh_terms: D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015984:Causality; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008199:Lymphadenitis / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008826:Microbial Sensitivity Tests; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D012961:Sociology; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents
keywords: abscess; infant; methicillin-resistant Staphylococcus aureus; staphylococcal infections