Cutaneous Abscesses in Children Epidemiology in the Era of Methicillin-Resistant Staphylococcus aureus in a Pediatric Emergency Department

Objective: Skin and soft tissue infections are a major public health issue. Previous literature suggests a recurrence rate of 4% in children. The purpose of this study was to examine the epidemiology, body location, and history of previous infections among children in the emergency department setting. Methods: A retrospective study was performed using electronic medical records from all subjects treated in a large pediatric emergency department with attending physician diagnosis and billing codes indicative of a cutaneous abscess from July 1, 2007, to December 31, 2007. Descriptive statistics were used to evaluate abscess location, prior history of infection, bacterial etiology, and patient disposition. Results: Three hundred eighteen abscess visits occurred in 308 individual subjects; 79% were due to methicillin-resistant Staphylococcus aureus. Approximately 14% of subjects presented with more than 1 abscess. Those 2 years or younger were more likely to have buttock abscesses (P < 0.001). Of the 192 subjects for whom responses were documented, 82 (43%) had a history of a prior abscess. Children 2 years or younger were significantly more likely to be hospitalized or go to the operating room: 49% versus 15% (P < 0.001). Conclusions: Many children with a cutaneous abscess have a prior history of infection. Multiple abscesses are common. Young children are more likely to have abscesses in the diaper area or be hospitalized. Studies of effective hygiene practices and interventions to reduce recurrence are urgently needed.