Display options
Cite
Yang T, Wang J, Cao J, et al. Antibiotic-resistant profile and the factors affecting the intravenous antibiotic treatment course of generalized Staphylococcal Scalded Skin Syndrome: a retrospective study. Ital J Pediatr. 2021;47(1):169doi: 10.1186/s13052-021-01120-6.
Yang, T., Wang, J., Cao, J., Zhang, X., Lai, Y., Li, L., Ye, X., & You, C. (2021). Antibiotic-resistant profile and the factors affecting the intravenous antibiotic treatment course of generalized Staphylococcal Scalded Skin Syndrome: a retrospective study. Italian journal of pediatrics, 47(1), 169. https://doi.org/10.1186/s13052-021-01120-6
Yang, Tao, et al. "Antibiotic-resistant profile and the factors affecting the intravenous antibiotic treatment course of generalized Staphylococcal Scalded Skin Syndrome: a retrospective study." Italian journal of pediatrics vol. 47,1 (2021): 169. doi: https://doi.org/10.1186/s13052-021-01120-6
Yang T, Wang J, Cao J, Zhang X, Lai Y, Li L, Ye X, You C. Antibiotic-resistant profile and the factors affecting the intravenous antibiotic treatment course of generalized Staphylococcal Scalded Skin Syndrome: a retrospective study. Ital J Pediatr. 2021 Aug 06;47(1):169. doi: 10.1186/s13052-021-01120-6. PMID: 34362428; PMCID: PMC8344213.
Copy Download .nbib Format: NLM
Share it on

Ital J Pediatr. 2021 Aug 06;47(1):169. doi: 10.1186/s13052-021-01120-6.

Antibiotic-resistant profile and the factors affecting the intravenous antibiotic treatment course of generalized Staphylococcal Scalded Skin Syndrome: a retrospective study.

Italian journal of pediatrics

Tao Yang, Jiangyi Wang, Junya Cao, Xinyue Zhang, Yun Lai, Longnian Li, Xiaoying Ye, Cong You

Affiliations

  1. Department of Dermatology and Venereology, Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases, The First Affiliated Hospital of Gannan Medical University, No. 23 Qingnian Road, Zhanggong District, Ganzhou, 341000, China.
  2. Department of Dermatology and Venereology, The General Hospital of Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.
  3. Department of Dermatology and Venereology, Candidate Branch of National Clinical Research Centre for Skin and Immune Diseases, The First Affiliated Hospital of Gannan Medical University, No. 23 Qingnian Road, Zhanggong District, Ganzhou, 341000, China. [email protected].

PMID: 34362428 PMCID: PMC8344213 DOI: 10.1186/s13052-021-01120-6

Abstract

BACKGROUND: Staphylococcal Scalded Skin Syndrome (SSSS) is caused by a special type of Staphylococcus aureus (S.aureus) which can produce exfoliative toxins. The generalized SSSS is recommended to be admitted and treated with intravenous antibiotics. However, there were limited reports on whether personal and clinical factors can have impacts on the duration of intravenous antibiotic application for pediatric patients with generalized SSSS. We performed a study to assess the factors affecting intravenous antibiotic treatment course of SSSS patients. Additionally, the positive culture rates of S.aureus in different samples and the antibiotic-resistant profile were investigated.

METHODS: Two hundred nineteen patients with generalized SSSS were included. Gender, age, area, season, maximum axillary temperature, white blood cell (WBC) count, C-reactive protein (CRP) level, types of intravenous antibiotics, and types of external antibiotics were recorded as the baseline. Simple linear regression was applied in the univariate analysis to determine the variables with statistical significance and then these variables were further examined in multivariate linear regression model. The positive culture rates of S.aureus in different sample sources were calculated and the drug sensitivity results were statistically compared by pairwise Chi square test.

RESULTS: According to the multiple linear regression, older ages (β = - 0.01, p < 0.05) and external application of fusidic acid (β = - 1.57, p < 0.05) were associated with shorter treatment course, elevated leukocytes (β = 0.11, p < 0.001) and CRP level (β = 1.64, p < 0.01) were associated with longer treatment course. The positive culture rates of periorificial swabs, throat swabs, and blood samples were 54.55, 30.77, and 5.97% respectively. The resistant rates of levofloxacin (8.33%), gentamycin (8.33%), tetracycline (25%), oxacillin (8.33%), vancomycin (0%) were significantly lower than the ones of erythromycin (100%), trimethoprim-sulfamethoxazole (TMP/SMX) (83.33%), clindamycin (91.67%), penicillin G(100%) (p < 0.001).

CONCLUSION: Elevated leukocytes and CRP level indicated prolonged intravenous antibiotic treatment course. Older ages and external application of fusidic acid helped to reduce the treatment course. Compared with blood samples, the culture positive rates of S.aureus in periorificial and throat swabs were higher. Oxacillin and vancomycin resistance was rare and clindamycin resistance was common. Clindamycin monotherapy for SSSS should be avoided.

© 2021. The Author(s).

Keywords: Antibiotic sensitivity; Intravenous antibiotic treatment; S. aureus; Staphylococcal Scalded Skin Syndrome

References

  1. J Eur Acad Dermatol Venereol. 2014 Nov;28(11):1418-23 - PubMed
  2. Emerg Microbes Infect. 2016 Dec 21;5(12):e127 - PubMed
  3. Infection. 2018 Feb;46(1):49-54 - PubMed
  4. Int J Antimicrob Agents. 2010 Feb;35(2):114-8 - PubMed
  5. Pediatr Crit Care Med. 2005 Jan;6(1):2-8 - PubMed
  6. FEMS Immunol Med Microbiol. 2012 Mar;64(2):212-8 - PubMed
  7. Arch Dis Child. 2014 Jun;99(6):493-9 - PubMed
  8. Br J Dermatol. 2018 Mar;178(3):704-708 - PubMed
  9. Pediatr Dermatol. 2020 Jan;37(1):222-223 - PubMed
  10. Clin Microbiol Infect. 2012 Dec;18(12):E514-21 - PubMed
  11. J Glob Infect Dis. 2009 Jan;1(1):45-7 - PubMed
  12. SAGE Open Med Case Rep. 2018 Jan 04;6:2050313X17750890 - PubMed
  13. J Paediatr Child Health. 2008 Jun;44(6):374-6 - PubMed
  14. Burns. 2012 Mar;38(2):296-300 - PubMed
  15. Arch Surg. 2007 Jul;142(7):639-42 - PubMed
  16. BMJ Case Rep. 2013 Jun 10;2013: - PubMed
  17. Clin Microbiol Infect. 2009 Nov;15(11):1026-32 - PubMed
  18. Oncotarget. 2017 Jul 22;8(35):58086-58097 - PubMed
  19. BMC Microbiol. 2020 Jun 29;20(1):183 - PubMed
  20. Open Microbiol J. 2016 Aug 31;10:150-9 - PubMed
  21. BMJ. 2006 Apr 8;332(7545):838-41 - PubMed
  22. Clin Microbiol Rev. 1999 Apr;12(2):224-42 - PubMed
  23. Am J Clin Dermatol. 2003;4(3):165-75 - PubMed
  24. J Pediatr. 2006 Nov;149(5):721-4 - PubMed
  25. Int J Emerg Med. 2008 Jun;1(2):85-90 - PubMed
  26. J Clin Microbiol. 2017 Aug;55(8):2529-2537 - PubMed
  27. Euro Surveill. 2014 Aug 21;19(33): - PubMed
  28. World J Pediatr. 2018 Apr;14(2):116-120 - PubMed
  29. Pediatr Dermatol. 2014 May-Jun;31(3):305-8 - PubMed
  30. Chest. 2004 Apr;125(4):1335-42 - PubMed
  31. Front Immunol. 2018 Apr 13;9:754 - PubMed
  32. Clin Microbiol Infect. 2005 Feb;11(2):101-8 - PubMed
  33. J Dermatol Sci. 2010 Sep;59(3):184-91 - PubMed
  34. J Am Acad Dermatol. 2018 Feb;78(2):404-406 - PubMed
  35. Pediatr Dermatol. 2014 Jan-Feb;31(1):43-7 - PubMed
  36. Clin Microbiol Rev. 2017 Oct;30(4):887-917 - PubMed
  37. Clin Microbiol Infect. 2001 Jun;7(6):301-7 - PubMed
  38. FEMS Immunol Med Microbiol. 2003 Nov 28;39(2):181-9 - PubMed
  39. AJP Rep. 2017 Apr;7(2):e134-e137 - PubMed

Publication Types

Grant support