611 - Skin and Soft Tissue Infections and Associated Complications in Children Aged 0-3 Years in Two Urban Multiethnic Community Hospitals

Poster Number: 611
Publication Number: 611.209

Maria Celeste Ruiz Holgado, FLUSHING HOSPITAL MEDICAL CENTER, Flushing, NY, United States; Ahmed S Youssef, Good Samaritan hospital, Mount Vernon, IL, United States; Lubna Rahman, Flushing Hospital Medical Center, Flushing, NY, United States; Radhika Maddali, Flushing Hospital Medical Center, Flushing, NY, United States; Tashalee McGrath-Blagrove, Flushing Hospital Medical Center, Planfield, NJ, United States; Lochana KC, Flushing Hospital Medical Center, Flushing, NY, United States; Tayyaba Wajih, Flushing Hospital Medical Center, Jamaica, NY, United States; Bipashna Malla, Flushing Hospital Medical Center, Flushing, NY, United States; Leidi Maylan Pedraza Gonzalez, Flushing Hospital Medical Center, Flushing, NY, United States; Lily Q. Lew, Flushing Hospital Medical Center, Flushing, NY, United States; Esra Fakioglu, Flushing Hospital Medical Center, Flushing, NY, United States

Background: Skin and soft tissue infections (SSTI) include cellulitis and abscess. Cellulitis is an infection of the deep dermis and abscess is collection of pus within the dermis and subcutaneous space. Complications of SSTI include bacteremia, lymphadenitis, endocarditis, septic arthritis or osteomyelitis, metastatic infection sepsis and toxic shock syndrome. There are no studies evaluating SSTI and complications and outcomes in children aged 0-3 years.

Objective: To determine the prevalence of positive and false-positive blood cultures and complications of SSTI.

Design/Methods: This was a retrospective chart review of SSTI in children aged 0-3 years in Flushing Hospital Medical Center and Jamaica Hospital Medical Center between Jan 2015 and Oct 2021. Data extracted from EHR include demographics (age, gender, ethnicity), clinical presentation, laboratory studies, imaging studies, antibiotic used, treatment course, complications and length of stay (LOS). Data were analyzed using percentages.

Results: Of 206 patients admitted for SSTI, about a half (48%) were abscesses, less than half (44%) cellulitis, few impetigo (6%) and staphylococcal scalded skin syndrome (2%). Most were male (52%), Hispanic (70%) and Asian (26%). A fifth (18%) had previous SSTI and a tenth (8%) had a positive family history. Of a third (36%) who had imaging studies, three quarters (76%) had an ultrasound, less than a half (44%) confirmed an abscess and less than a third (29%) soft tissue infection. Almost all (94%) had a blood culture and most a wound culture (59%). Of the positive blood cultures (4%), majority (78%) were contaminants or normal skin flora and remainder (22%) Staphylococcus aureus. Of the positive wound cultures, most (86%) were Staphylococcus aureus. Methicillin-sensitive (MSSA) was equal to methicillin-resistant (MRSA) (44% vs 43%). Of the 11% having complications, the most common was lymphadenitis (6%). Clindamycin was the antibiotic of choice in most (70%) and 14% required a change in antibiotic due to susceptibility pattern. The median LOS was 3 days.Conclusion(s): The most common SSTI in children aged 0-3 years is abscess and cellulitis. The yield of blood cultures is low. Prevalence of MRSA was equal to MSSA. Knowing the low prevalence of complications in children with SSTI, healthcare providers can provide appropriate antibiotic coverage and disposition for SSTI in our community.