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Keywords:

  • MRSA;
  • methicillin resistant staphylococcus aureus;
  • cervical;
  • neck;
  • pediatric;
  • abscess;
  • infection;
  • Level of Evidence: 2b.

Abstract

Objectives/Hypothesis:

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

Study Design:

Retrospective cohort study.

Methods:

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.

Results:

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.

Conclusions:

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. Laryngoscope, 2011