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

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Abstract

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.

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Data availability

The data that support the fndings of this study are available from the corresponding author upon reasonable request.

Abbreviations

CAM:

Amoxicillin-clavulanate

SAM:

Ampicillin-sulbactam

ESBL:

Extended-spectrum beta-lactamase

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Funding

No specific funding was provided for this study.

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Authors and Affiliations

  1. Department of Pediatric Infectious Diseases, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Konak, Izmir, 35210, Turkey

    Gizem Guner Ozenen, Aybuke Akaslan Kara, Arife Ozer, Pelin Kacar, Deniz Ergun, Nuri Bayram & Ilker Devrim

  2. Department of Pediatrics, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir, Turkey

    Aysenur Aydin

  3. Department of Pediatric Surgery, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir, Turkey

    Incinur Genisol Ataman, Kamer Polatdemir, Ayse Demet Payza & Akgun Oral

  4. Department of Medical Microbiology, University of Health Sciences Dr. Behçet Uz Children’s Hospital, Izmir, Turkey

    Yelda Sorguc

Authors
  1. Gizem Guner Ozenen
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Contributions

GGO: Analysis and interpretation, data collection, writing the article, AAK: Analysis and interpretation, data collection, AO: Analysis and interpretation, data collection, PK: Analysis and interpretation, data collection, DE: Analysis and interpretation, data collection, AA: Data collection, IAG: Analysis and interpretation, data collection, KP: Analysis and interpretation, data collection, ADP: Analysis and interpretation, data collection, YS: Analysis and interpretation, critical revision of the article, AO: Analysis and interpretation, data collection, NB: Conception and design, critical revision of the article, ID: Conception and design, critical revision of the article. All authors listed reviewed the final version of the manuscript and approved it for publication.

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Correspondence to Gizem Guner Ozenen.

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Guner Ozenen, G., Akaslan Kara, A., Ozer, A. et al. Perianal abscess in children: an evaluation of microbiological etiology and the effectiveness of antibiotics. Pediatr Surg Int 39, 272 (2023). https://doi.org/10.1007/s00383-023-05556-1

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