Perianal abscess in children: an evaluation of microbiological etiology and the effectiveness of antibiotics

• Published in: Pediatric surgery international 2023-09, Vol.39 (1), p.272-272, Article 272
• Main Authors: Guner Ozenen, Gizem, Akaslan Kara, Aybuke, Ozer, Arife, Kacar, Pelin, Ergun, Deniz, Aydin, Aysenur, Genisol Ataman, Incinur, Polatdemir, Kamer, Payza, Ayse Demet, Sorguc, Yelda, Oral, Akgun, Bayram, Nuri, Devrim, Ilker
• Format: Article
• Language: English
• Subjects: Abscess - drug therapy; Abscess - microbiology; Abscesses; Adolescent; Anti-Bacterial Agents - therapeutic use; Antibiotics; Anus Diseases; Bacteria; Child; Child, Preschool; Female; Gram-negative bacteria; Gram-positive bacteria; Gram-Positive Bacteria - drug effects; Gram-Positive Bacterial Infections - drug therapy; Humans; Infant; Male; Medicine; Medicine & Public Health; Original Article; Pediatric Surgery; Pediatrics; Retrospective Studies; Surgery
• ISSN: 1437-9813; 0179-0358; 1437-9813
• DOI: 10.1007/s00383-023-05556-1

Purpose We aimed to evaluate the demographic characteristics of children with perianal abscess, distribution of microbiological etiology, antibiotic susceptibility, and identify the effectiveness and coverage of antibiotics due to culture results. Methods A retrospective study was designed to evaluate pediatric patients with perianal abscesses between January 2013 and December 2022. Results A total of 197 episodes in 135 patients were evaluated. The median age of the patients was 10 months (22 days–17 years). The isolated microorganisms were Gram-positive bacteria in 56 (28.4%) patients and Gram-negative bacteria in 141 (71.6%) patients. The most common isolated species was Escherichia coli ( n  = 70, 35.5%), followed by Klebsiella spp. ( n  = 48, 24.4%), Staphylococcus aureus ( n  = 37, 18.9%), and Enterobacter spp. ( n  = 9, 4.5%). Forthy-two percent ( n  = 58) of isolates were positive for extended-spectrum beta-lactamase, 8% ( n  = 11) were carbapenem-resistant in Gram-negative bacteria, and 37.5% ( n  = 21) were methicillin-resistant, 7.1% ( n  = 4) were vancomycin-resistant in Gram-positive bacteria. According to bacterial culture results, ertapenem plus glycopeptide had the highest antimicrobial coverage rate (92.3%), followed by ertapenem plus clindamycin (89.8%), ertapenem (81.7%), third-generation cephalosporin plus glycopeptide (82.2%), third-generation cephalosporin plus clindamycin (69.5%). Conclusion Ertapenem can be a good choice in the empirical treatment of perianal abscesses in children due to its high coverage rate.