The increased risk of community-acquired methicillin-resistant Staphylococcus aureus neck abscesses in young children.

Abstract

To analyze the microbiological origins of deep neck space infections requiring surgical intervention in a pediatric population. Retrospective cohort study. 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. 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. 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.