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Antibiotic sensitivity and clinical outcomes in staphylococcal scalded skin syndrome

Zixiao Wang1, Jessica L Feig1, Diana B Mannschreck1

  • 1Department of Dermatology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.

Pediatric Dermatology
|October 19, 2019
PubMed

Insights

Staphylococcal scalded skin syndrome (SSSS) in infants often shows clindamycin resistance. Cephalosporins and penicillinase-resistant penicillins are recommended for empiric therapy, with MRSA coverage considered if needed.

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Microbiology

Background:

  • Staphylococcal scalded skin syndrome (SSSS) primarily affects infants under one year old, causing extensive skin peeling.
  • Increasing antibiotic resistance in community-acquired staphylococcal infections complicates empiric treatment choices for SSSS.
  • Previous studies and this review indicate a concerning trend of antibiotic resistance in SSSS-associated isolates.

Purpose of the Study:

  • To analyze antibiotic resistance patterns in Staphylococcus isolates associated with SSSS.
  • To guide the selection of appropriate empiric antibiotic therapy for SSSS in infants.
  • To compare resistance profiles of SSSS isolates with overall staphylococcal infections.

Main Methods:

  • Retrospective review of SSSS cases and associated Staphylococcus isolates.
  • Analysis of antibiotic susceptibility data, focusing on clindamycin and methicillin resistance.
  • Comparison of resistance rates between SSSS isolates and a broader group of staphylococcal infections.

Main Results:

  • SSSS-associated isolates demonstrated higher rates of clindamycin resistance compared to overall staphylococcal infections.
  • Conversely, SSSS-associated isolates were less likely to be methicillin-resistant than overall staphylococcal infections.
  • These findings highlight specific resistance patterns relevant to SSSS empiric treatment.

Conclusions:

  • For empiric management of SSSS, cephalosporins and penicillinase-resistant penicillins (e.g., oxacillin) are favored.
  • Consideration should be given to adding Methicillin-resistant Staphylococcus aureus (MRSA) coverage in areas with high MRSA prevalence.
  • Adding MRSA coverage may also be indicated if initial treatment fails to improve SSSS symptoms after several days.

Keywords:
Staphylococcus aureusMRSASSSSantibiotic resistancescalded skin syndrome

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