当前位置： SCI文献检索 > PEDIATRIC EMERGENCY CARE期刊下所有文献 > Emergency department treatment failures for skin infections in the era of community-acquired methicillin-resistant Staphylococcus aureus.

Emergency department treatment failures for skin infections in the era of community-acquired methicillin-resistant Staphylococcus aureus.

Abstract：

BACKGROUND:Despite rapidly increasing incidence of skin and soft tissue infections (SSTIs) presenting to emergency departments (EDs), outcome data for these infections are limited. METHODS:This is a retrospective cohort study of children with culture-positive SSTI, managed as outpatients from a large pediatric ED in the year 2006. The primary outcome was treatment failure, defined as presence of 1 or more of the following: (1) change in antibiotic owing to poor clinical response, (2) subsequent incision and drainage, or (3) hospitalization. Demographics, isolated pathogens, and therapeutics were also assessed. To accurately capture the outcome of interest, only children who are observed in the hospital-based primary care network were included. RESULTS:Among 148 eligible subjects, there were 158 SSTIs including 131 abscesses, 19 folliculitis, and 8 cellulitis. Mean age was 9.1 ± 6.2 years, 41.2% were male, and 94.6% were African American. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated in 66%, methicillin-sensitive S. aureus (MSSA) in 21%, and others in 13%. Outcome data were available for 144 subjects (97.2%). Emergency department treatment failure rate was 7.6% (95% confidence interval, 3.3%-12.0%); 10 of 11 failures were abscesses. Only S. aureus produced treatment failure and occurred in 13.3% of MSSA and 6.4% MRSA infections (odds ratio, 1.9; 95% CI, 0.5-7.1). An antibiotic to which the organism was sensitive was prescribed for 9 (81.8%) of 11 treatment failures and did not differ between MRSA and MSSA; appropriate antibiotics were used in 91.5% of treatment successes. CONCLUSIONS:The rate of ED treatment failure for SSTI is low and is more likely to occur with S. aureus infection, irrespective of methicillin resistance or appropriate antibiotic therapy.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Mistry RD,Scott HF,Zaoutis TE,Alpern ER

doi

10.1097/PEC.0b013e318203ca1c

subject

Has Abstract

pub_date

2011-01-01 00:00:00

pages

21-6

issue

eissn

0749-5161

issn

1535-1815

journal_volume

pub_type

杂志文章

在线工具

Emergency department treatment failures for skin infections in the era of community-acquired methicillin-resistant Staphylococcus aureus.