Bacteriologic Profile Along With Antimicrobial Susceptibility Pattern of Pediatric Pyoderma in Eastern India

Abstract

BackgroundPyogenic skin infection (pyoderma) is a bacterial infection of the skin and its appendages. Primary pyoderma is caused by the direct invasion of healthy skin, whereas secondary pyoderma originates in diseased skin as superimposed conditions, such as scabies, pediculosis, wounds, insect bites, and eczema. This study aimed to identify the clinical patterns and risk factors of pyoderma in a pediatric population and to isolate various causative bacteria and determine their susceptibility patterns. MethodologyA prospective study was performed at the Medical College and Hospital, Kolkata, India, for one year (from August 2016 to July 2017), which included all children younger than 12 years with pyoderma attending the outpatient dermatology department (as the study was conducted among the pediatric population, only children below 12 years of age were included). Sterile cotton swabs were used to aseptically collect exudates or pus from lesions and anterior nares, which were used for culture, identification, and antibiotic susceptibility testing of the causative organisms. ResultsDuring the study period, a total of 182 patients were included, 121 (66.48%) of whom had primary pyoderma and 61 (33.52%) of whom had secondary pyoderma. Of the 182 patients, 161 showed bacterial growth on culture: 126 (78.26%) were Staphylococcus aureus, 18 (11.18%) were coagulase-negative staphylococci, 16 (9.94%) were Streptococcus pyogenes, and 1 (0.62%) was Pseudomonas aeruginosa. All staphylococci were susceptible to vancomycin and linezolid. ConclusionsThe most common cause of pyoderma in the pediatric age group is S. aureus, although the prevalence of methicillin-resistant S. aureus was low in this hospital. Proper identification and antibiogram are required for managing these cases.

Detection of Genes Encoding Microbial Surface Component Recognizing Adhesive Matrix Molecules in Methicillin-Resistant Staphylococcus aureus Isolated from Pyoderma Patients

“…Primary pyoderma was more frequent (89; 76.72%) than secondary pyoderma (27; 23.28%). The higher prevalence of primary pyoderma was also reported in a previous report, which strengthens the findings of this study [ 20 ]. The detailed history of patients revealed that the majority of patients (97; 83.62%) never visited the clinical laboratories for the pus culture and sensitivity.…”

“…In the present study, S. aureus isolates exhibited decreased (23.3–53.4%) susceptibility to penicillin, cefoxitin, erythromycin, ciprofloxacin, tetracycline and trimethoprim–sulfamethoxazole ( Table 2 ). Nonetheless, all the isolates appeared susceptible to linezolid, which was in line with the findings of earlier studies [ 19 , 20 ]. Linezolid-resistant Staphylococcus isolates have not been frequently reported.…”

“…An earlier report also corroborated the male preponderance for pyoderma cases [ 18 ]. Contrarily, a study from India reported the female preponderance [ 20 ] that can be understood by considering the different societal norms in the two countries. In this study, most patients (100/116; 86.20%) had localized infections in just a part of the body.…”

“…Nevertheless, Qodrati et al [ 23 ] reported similar findings except the pattern for erythromycin susceptibility that may be linked with the collection of MRSA isolates from the hospitalized patients. Nonetheless, the effectiveness of these antibiotics along with linezolid that exhibited good inhibitory activity is also subject to its cost, which can be a determining factor in many developing countries [ 20 , 22 ]. The availability of antibiotics as over-the-counter drugs hampers resistance in low-income regions, particularly in community-acquired infections; nevertheless, the high cost of antibiotics limits its use and, hence, a lower resistance is observed for such drugs.…”

Prevalence of Methicillin Resistance Staphylococcus aureus in Community Cases of Pyoderma

“…This has been related to under developed epidermal barrier in children and adolescents. A male predominance was noted, consistent with other studies [9][10] . This could be due to higher probability of occupational hazards and exposure to bacteria in males.…”