Childhood peripheral skin and soft tissue abscesses
Çağatay Evrim Afşarlar 1, Ayşe Karaman 1, Gönül Tanır 2, İbrahim Karaman 1, Engin Yılmaz 1, Derya Erdoğan 1, Haşim Ata Maden 1, Yusuf Hakan Çavuşoğlu 1, İsmet Faruk Özgüner 1
1Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk Cerrahisi Kliniği, Ankara
2Dr. Sami Ulus Kadın Doğum, Çocuk Sağlığı ve Hastalıkları Eğitim ve Araştırma Hastanesi, Çocuk İnfeksiyon Hastalıkları Kliniği, Ankara
Keywords: Abscess, child, soft tissue, skin
Abstract
Objective: The types of microorganisms that underlie community associated peripheral skin and soft tissue abscesses and methicillin resistant Staphylococcus aureus (MRSA) incidence are variable, as well as, treatment options are still controversial. Thus, we aimed to investigate the demographic features, abscess localizations, causative microorganisms, treatment modalities, and efficacy of the administrated antimicrobiological agents of the patients with peripheral skin and soft tissue abscess who were referred to our department serving a large population.
Methods: In a period of January 2005 to July 2010 patients referred to our department complaining of peripheral localized abscess were investigated retrospectively. Abscesses were classified into three groups as head&neck, body, and extremity abscesses according to the localization. Demographic features of the patients, abscess characteristics and treatment modalities were investigated.
Results: For a period of 5 years, 90 cases (49 male, 41 female) with a median age of 2.55 years referred to our department. While the head&neck abscess were common in girls (65.4 %), extremity abscesses were common in boys (68.4 %). Commonly head&neck and body abscesses were hospitalized. The most frequent microorganisms isolated from the cultures were Staphylococcus aureus and Streptococcus strains (69.2 %). There was no statistically significance between the type of microorganism and abscess size, localization and hospitalization (p>0.05), but abscess size was larger among hospitalized patients (p=0.001). Frequently used antibiotics were amoxicillin/clavulanate and sulbactam/ampicillin (76.6 %). Duration of treatment was significantly longer among inpatients in comparison with outpatients (p=0.001).
Conclusion: Primary treatment of the community associated peripheral abscesses is surgical drainage. The MRSA stains have an increasing isolation in the cultures of community-associated skin and soft tissue abscesses in the western populations for the last years, but MRSA strain was not isolated in the cultures of our study group. Although antibiotic treatment is controversial, the choice of sulbactam/ampicillin and amoxicillin/clavulanate preparations was effective in empiric treatment of childhood community associated skin and soft tissue abscesses.