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Retropharyngeal Abscess in Children: The Rising Incidence of Methicillin-Resistant Staphylococcus aureus
The Pediatric Infectious Disease Journal, 06/22/2012
Abdel–Haq N et al. – Retropharyngeal abscess (RPA) has increased in frequency in pediatric population with an associated increase of Staphylococcus aureus, mainly community–associated methicillin–resistant Staphylococcus aureus (MRSA). This is likely due to the overall increase in community–associated MRSA infections in pediatric patients. Treatment with ceftriaxone and clindamycin in addition to surgical drainage was effective.
Methods- A retrospective review of medical records of children with RPA.
- One hundred fourteen children (61 males) with RPA were identified representing a 2.8-fold increase in incidence (per 10,000 admissions) over the previous 11-year period.
- Abscess drainage was performed in 74 (65%). A total of 116 isolates (93 aerobes, 23 anaerobes) were recovered from 66 specimens.
- S. aureus was recovered from 25 (38%) of the 66 specimens compared with 2 (4.9%) of 41 in the previous 11 years; 16 (64%) of 25 were MRSA compared with none in the previous 11 years.
- Children whose abscess grew MRSA were younger (mean 11 months) than the others (mean 62 months) (P < 0.001) and required longer duration of hospitalization (mean 8.8 days) than the rest (mean 4.5 days) (P = 0.002).
- Five children had mediastinitis; all caused by MRSA.
- All MRSA isolates were susceptible to clindamycin. Ceftriaxone plus clindamycin was the most common treatment regimen. All patients had resolution of their abscesses.