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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)

Published on: February 9, 2011

Pediatric mediastinitis as a complication of methicillin-resistant Staphylococcus aureus retropharyngeal abscess

Charles T Wright1, Rose Mary S Stocks, David L Armstrong

  • 1Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Archives of Otolaryngology--Head & Neck Surgery
|April 23, 2008
PubMed

Insights

Retropharyngeal infection cases doubled, with methicillin-resistant Staphylococcus aureus (MRSA) becoming a significant cause, particularly in infants. MRSA is strongly linked to mediastinitis, necessitating a higher index of suspicion in young children.

Area of Science:

  • Pediatric Infectious Diseases
  • Otolaryngology
  • Microbiology

Background:

  • Retropharyngeal infection (RPI) is a serious condition in children.
  • Changes in RPI incidence and causative agents can impact clinical management.
  • Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging pathogen in various infections.

Purpose of the Study:

  • To analyze trends in RPI incidence, bacteriology, and complications over an 8-year period.
  • To identify changes in the types of bacteria causing RPI.
  • To assess the association between specific pathogens and RPI complications.

Main Methods:

  • Retrospective review of medical records of 108 pediatric patients with RPI.
  • Comparison of RPI cases from two 4-year periods (June 1997-May 2001 and June 2001-May 2005).
  • Analysis of bacteriology, including MRSA detection, and complication rates, such as mediastinitis.

Main Results:

  • The incidence of RPI doubled in the latter 4-year period.
  • MRSA was identified in 32% of positive cultures in the later period, compared to 0% in the earlier period.
  • Seven cases of mediastinitis occurred in the latter 4 years, with 6 associated with MRSA infections in younger children.

Conclusions:

  • RPI incidence has significantly increased, with MRSA emerging as a key pathogen.
  • MRSA RPI is strongly associated with mediastinitis, particularly in infants under one year old.
  • Increased clinical suspicion for MRSA is crucial in young children with RPI, especially those presenting with severe complications.
Abstract

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