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Outcomes After Skin and Soft Tissue Infection in Infants 90 Days Old or Younger

Gabrielle Hester1, Adam L Hersh2, Michael Mundorff3

  • 1Department of Hospital Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, Minnesota; gabrielle.hester@childrensmn.org.

Hospital Pediatrics
|November 4, 2015
PubMed

Insights

Skin and soft tissue infections (SSTIs) in infants rarely involve invasive bacterial infections. However, treatment failure requiring hospital readmission is common, particularly for perianal infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Neonatal Care
  • Hospital Epidemiology

Background:

  • Skin and soft tissue infections (SSTIs) are a frequent reason for infant hospitalizations.
  • Optimal diagnostic strategies for infants with SSTIs are unclear, especially regarding risks of concurrent infections and treatment outcomes.
  • Limited data exists on invasive bacterial infections (IBI) and treatment failure in young infants with SSTIs.

Purpose of the Study:

  • To determine the incidence of concomitant invasive bacterial infections (IBI) in infants with SSTIs.
  • To assess the rate of hospital revisits due to treatment failure within 14 days of discharge.
  • To identify factors associated with treatment failure in infants diagnosed with SSTIs.

Main Methods:

  • Retrospective study of 172 infants aged ≤90 days with SSTI diagnosis.
  • Data collected from July 2004 to December 2011 across 22 healthcare facilities.
  • Concomitant infections defined as culture-confirmed UTI or IBI; treatment failure as unplanned care changes upon revisit.

Main Results:

  • Concomitant bacterial infections were rare (0.58%), with one case of bacteremia in a febrile infant.
  • No cases of missed urinary tract infection (UTI) or invasive bacterial infection (IBI) were identified upon revisit.
  • Treatment failure occurred in 9.3% of infants, with perianal location and private insurance linked to higher failure rates.

Conclusions:

  • Concomitant invasive bacterial infections are uncommon in infants with SSTIs, particularly in afebrile infants.
  • Treatment failure leading to hospital readmission is a significant concern in this population.
  • Further research into risk factors and management strategies for SSTI treatment failure in infants is warranted.
Abstract

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