Ten-Year Epidemiology and Antimicrobial Susceptibility of Pediatric Staphylococcal Scalded Skin Syndrome: A Retrospective Study From a Tertiary Referral Center.

Abstract

Background/objectives: Staphylococcal scalded skin syndrome (SSSS) is a toxin-mediated dermatologic emergency that predominantly affects infants and young children. Despite its characteristic clinical presentation, data on long-term epidemiologic patterns and antimicrobial susceptibility in pediatric SSSS remain limited. This study aimed to describe demographic features, microbiological findings, and antimicrobial susceptibility trends in children with SSSS over a 10-year period preceding the COVID-19 pandemic.

Methods: We retrospectively reviewed children diagnosed with SSSS who were admitted to a tertiary pediatric referral center between 2009 and 2018. Demographic, clinical, and microbiological data were collected, and antimicrobial susceptibility results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) criteria, with methicillin susceptibility assessed using oxacillin or cloxacillin, and inducible clindamycin resistance excluded by D-test.

Results: A total of 120 children were included, the majority of whom were infants. Cases demonstrated a clear seasonal variation, with higher incidence during warmer months, although Winter represented the second most frequent season. Staphylococcus aureus was the predominant organism isolated from secretion cultures, while blood cultures were infrequently positive. No phenotypically confirmed methicillin-resistant S. aureus was identified. Susceptibility to first-line β-lactam antibiotics remained high, and clindamycin susceptibility was preserved without evidence of inducible resistance. Clinical outcomes were favorable, with short hospital stays and no in-hospital mortality.

Conclusions: Methicillin-susceptible S. aureus continues to be the principal pathogen in pediatric SSSS, with sustained susceptibility to first-line β-lactam agents. These findings support current empiric treatment strategies and provide a robust regional baseline for future antimicrobial resistance surveillance.