Staphylococcal scalded skin syndrome in a newborn

Jeyakumari, D; Gopal, R; Eswaran, M. Arthanari; MaheshKumar, C

doi:10.4103/0974-777x.52981

Cited by 14 publications

(4 citation statements)

References 3 publications

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“…In the final multiple linear regression model, younger ages were associated with longer intravenous antibiotic treatment duration. There have been reports demonstrating that lack of protective antibodies to exfoliative toxins, immature renal function with a decreased renal clearance of these toxins at a young age may account for the increased incidence at a younger age [ 13 , 14 , 26 ]. We speculate that older children could have increased titers of protective antibodies to exfoliative toxins and increased renal clearance of these toxins, which may be helpful for the reduction of the intravenous antibiotic treatment course.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…In the nal multiple linear regression model, younger ages were associated with longer intravenous antibiotic treatment duration. There have been reports demonstrating that lack of protective antibodies to exfoliative toxins, immature renal function with a decreased renal clearance of these toxins at a young age may account for the increased incidence at a younger age [12,13,25]. We speculate that older children could have increased titers of protective antibodies to exfoliative toxins and increased renal clearance of these toxins, which may be helpful for the reduction of the intravenous antibiotic treatment course.…”

Section: Discussionmentioning

confidence: 84%

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

Yang

Wang

Cao

et al. 2021

Preprint

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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: 219 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 samples and the drug sensitivity results were statistically compared by Fisher’s exact test and pairwise Chi square test respectively. 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 (54.55%) and throat swabs (30.77%) were higher than the ones of blood samples (5.97%) (p <0.01). 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. Periorificial and throat swabs were useful to identify causative S.aureus. Oxacillin and vancomycin resistance was rare and clindamycin resistance was common. Clindamycin monotherapy for SSSS should be avoided.

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“…Low titers of antibodies against exfoliative toxins and limited capacity for renal clearance of the toxin at a young age may lead to a relatively high incidence of SSSS at a younger age. 6 , 23 , 42 Therefore, we speculate that the increased antibody titers and renal clearance capacity in older children might be favorable in the reduction of the length of intravenous antibiotic treatment course. Larger studies investigating the clinical responses of SSSS patients of different age groups are necessary.…”

Section: Discussionmentioning

confidence: 96%

Associated Outcomes of Different Intravenous Antibiotics Combined with 2% Mupirocin Ointment in the Treatment of Pediatric Patients with Staphylococcal Scalded Skin Syndrome

You¹,

Wu²,

Liao³

et al. 2023

CCID

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To compare treatment duration, influencing factors, and costs among intravenous antibiotic groups combined with 2% mupirocin ointment for treating staphylococcal scalded skin syndrome (SSSS). Patients and Methods: Sex, age, onset days before admission, febrile status, white blood cell (WBC) count, and C-reactive protein (CRP) level were recorded as baseline characteristics for 253 included patients. The antibiotic sensitivity results were statistically compared by Cochran's Q test. Kruskal-Wallis tests were used to compare days and the total costs of hospitalization with different intravenous antibiotic applications. Mann-Whitney U-tests or Spearman's rank correlation tests were used for the univariate analysis. Finally, a multivariate linear regression model was employed to determine the variables with statistical significance. Results: The sensitivity rates of oxacillin (84.62%), vancomycin (100%), and mupirocin (100%) were significantly higher than those of clindamycin (7.69%) (p<0.0001). The duration of intravenous ceftriaxone administration was significantly longer than that of amoxicillin-clavulanic acid, cefathiamidine, and cefuroxime (p<0.01). The total hospitalization costs for cefathiamidine were significantly higher than those for amoxicillin-clavulanic acid and cefuroxime (p<0.05). According to the multiple linear regression, ages ≥60 months old were correlated with shorter treatment duration (β=−1.48, [95% CI: −2.29, −0.66] for amoxicillin-clavulanic acid, and β=−1.44, [95% CI: −2.06, −0.83] for cefathiamidine, and β=−0.96, [95% CI: −1.58, −0.34] for cefuroxime) (all p<0.01). In multivariate analysis for cefathiamidine, higher WBC count (β=0.05, [95% CI: 0.01, 0.10], p<0.05) and CRP level (β=1.12, [95% CI: 0.14, 2.10], p<0.05) were associated with longer treatment course. Conclusion: Oxacillin resistance was rare, and clindamycin resistance was high in pediatric patients with SSSS in our district. Intravenous amoxicillin-clavulanic acid and cefuroxime combined with topical mupirocin were favorable due to a shorter intravenous treatment course and lower costs. Younger age, elevated WBC count, and CRP levels could indicate a longer course of treatment with intravenous antibiotics.

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Staphylococcal scalded skin syndrome in a newborn

Cited by 14 publications

References 3 publications

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

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

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

Associated Outcomes of Different Intravenous Antibiotics Combined with 2% Mupirocin Ointment in the Treatment of Pediatric Patients with Staphylococcal Scalded Skin Syndrome

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