Korean J Pediatr Infect Dis.  2008 Dec;15(2):152-161. 10.14776/kjpid.2008.15.2.152.

Clinical Features and the Associated Factors of Staphylococcal Scalded Skin Syndrome during the Recent 10 Years

• Park CH
• Na SR
• Cho HM
• Yoo EJ
• Jung K
• Kim EY
• Kim YW
• Kim KS

• KMID: 2439926
• DOI: http://doi.org/10.14776/kjpid.2008.15.2.152

Abstract

PURPOSE
Staphylococcal scalded skin syndrome (4S) is uncommon, but reports of 4S are on the increase during the recent years. The purpose of this study is to determine the clinical features and associated factors of 4S during the recent 10 years.
METHODS
We retrospectively reviewed the medical records and microbiologic results of 63 patients (27 neonates and 36 children) from January 1998 to December 2007.
RESULTS
Since 2003, the incidence of 4S has increased. The mean age of the patients was 16.3 months and the gender ratio was 1:1. The clinical types of 4S were 38 cases of the abortive type (60%), 19 cases of the intermediate type (30%) and 6 cases of the generalized type (10%). The culture results were 36 cases of Methicillin resistant S. aureus (MRSA), 4 cases of Methicillin sensitive S. aureus and 17 cases of no growth. The patients were treated with semi-synthetic penicillin. For the 9 patients who had MRSA isolated and who didn't improve with penicillin, they were treated with vancomycin instead of penicillin. All the patients had no complications. 4S abruptly increased in 2005, and especially in neonates, due to an MRSA outbreak at a local nursery room. The associated factors of 4S in neonates were hospitalization (27 cases), including nursery infection in 2005 (18 cases) and dermatitis (1 case). There was an unknown origin for some children, and the suggested factors for their infection were community acquired infection (24 cases), atopic dermatitis (9 cases) and hospitalization (3 cases).
CONCLUSION
4S has recently been increasing. The major associated factors of 4S are a history of hospitalization, an outbreak in a nursery room, atopic dermatitis and community acquired infection.

Keyword

Staphylococcal scalded skin syndrome; Methicillin resistant Staphylococcal aureus; Community; Risk factors

MeSH Terms

Child
Dermatitis
Dermatitis, Atopic
Hospitalization
Humans
Incidence
Infant, Newborn
Medical Records
Methicillin
Methicillin Resistance
Methicillin-Resistant Staphylococcus aureus
Nurseries
Penicillins
Retrospective Studies
Risk Factors
Staphylococcal Scalded Skin Syndrome*
Vancomycin
Methicillin
Penicillins
Vancomycin