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Antimicrobial therapy of skin and soft tissue infection in children
1Department of Pediatrics, Georgetown University School of Medicine, Washington, DC.
Abstract:
Skin and soft tissue infection and cutaneous abscesses are common in children. They may be polymicrobial in nature, especially when located proximal to mucous membranes. A general knowledge of the common causative bacterial organisms in these infections enables the physician to empirically institute antimicrobial therapy before culture results are available. This review assesses the number and types of aerobic and anaerobic bacteria that occur in skin and soft tissue infections in children. Staphylococcus aureus and Streptococcus pyogenes were recovered from infections occurring at all body sites, but predominated in infections of the leg, neck, and hand. Group D streptococci, Enterobacteriaceae, Neisseria gonorrhoeae, Bacteroides fragilis, and Prevotella species were isolated mostly from infections of the external genitalia and perirectal areas; pigmented Prevotella and Porphyromonas and Haemophilus influenzae can be isolated from infections of the head and neck. Management of skin and soft tissue infections in children should include surgical and medical therapy.
Insights
Common pediatric skin infections often involve multiple bacteria, particularly near mucous membranes. Identifying common pathogens like Staphylococcus aureus and Streptococcus pyogenes guides early treatment for these common childhood infections.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Dermatology
Background:
- Skin and soft tissue infections (SSTIs) and cutaneous abscesses are frequent pediatric conditions.
- These infections can be polymicrobial, especially when located near mucous membranes.
- Understanding common bacterial culprits aids in empirical antimicrobial therapy before definitive culture results.
Purpose of the Study:
- To review the types and prevalence of aerobic and anaerobic bacteria in pediatric SSTIs.
- To correlate specific bacterial isolates with anatomical locations of infection.
- To inform clinical management strategies for pediatric SSTIs.
Main Methods:
- Literature review of studies reporting bacterial isolates from pediatric skin and soft tissue infections.
- Analysis of bacterial species identified in relation to infection site.
- Synthesis of findings on common aerobic and anaerobic pathogens.
Main Results:
- Staphylococcus aureus and Streptococcus pyogenes were prevalent across all body sites, particularly on the leg, neck, and hand.
- Group D streptococci, Enterobacteriaceae, Neisseria gonorrhoeae, Bacteroides fragilis, and Prevotella species were common in infections of the external genitalia and perirectal areas.
- Pigmented Prevotella, Porphyromonas, and Haemophilus influenzae were associated with head and neck infections.
Conclusions:
- Effective management of pediatric SSTIs requires a combination of surgical and medical interventions.
- Knowledge of common bacterial pathogens and their typical locations is crucial for timely and appropriate treatment.
- Antimicrobial therapy should be guided by the likely causative organisms based on infection site and clinical presentation.