Investigation of patients which were installed with the diagnosis of skin and soft tissue infection in the Children's Infectious Diseases Clinic: A ten-year retrospective assessment

Skin and soft tissue infections (SSTI) are common in childhood. Most are outpatients, but the invasive types require hospitalization. In this thesis study, it was aimed to retrospectively evaluate the demographic, clinical, laboratory, risk factors and prognostic data of 355 cases hospitalized in the Pediatric Infectious Diseases Clinic (PIDC) with the diagnosis of skin and soft tissue infection in a ten-year period (2009-2018). In a 10-year period, patients hospitalized with the diagnosis of SSTI constituted 0.9% of all cases admitted to the Child Health and Diseases (CHDC) clinic, and 8% of all cases admitted to PIDC. Among SDIs, cellulitis 31% (n=111), preseptal cellulitis 24.2% (n=86), cervical lymph node abscess 10% (n=34), subcutaneous abscess 10% (n=36), impetigo 8% (n=29) was detected. The median age of the cases was 6 years, 60.3% (n=214) were male. The median duration of symptoms before admission was 5 days. 26% (n=93) of the cases had chronic disease. Before admission, 52% (n=182) of the cases had used antibiotics. In 16% (n=57) of the cases, the causative agent grew in blood or wound/abscess culture during hospitalization. The most frequently detected microorganisms were S. aureus (46%, MRSA (%7), MSSA (%37)), streptococcus spp. (16%) and coagulase negative staphylococci (14%). Six patients had intensive care admissions. Empirical parenteral antibiotics were started in all cases, and drainage and/or surgical treatment were applied in addition to 16% of cases (n=56). The median total hospital stay was 6 days. Patients with chronic disease, intensive care unit stay (ICU), and hospital stay (median 7, 8, 7 days, respectively) were significantly shorter than those who underwent surgery/drainage (11 days) (p<0.05). The mean total hospitalization cost of each case was 780,41 TL (1075,23±1146,05, 46,2-11531,59), and the average daily cost was 135 TL (600,52±1339,27, 14,03-3913,94). Average total hospitalization cost in dollars (10-year average rate of $, 1$= 2.45 TL) 255.77 $ (418.69± 564.31, 53.48- 7252.57), average daily cost 43.36 $ (58.33±142.91, 5.17- 2574.96). No cases were lost. As a result; SDI cases constituted approximately 1% of all patients admitted to CHDC and 8% of all patients admitted to PIDC. MSSA (%39) was most common and mean hospital stay was 6 days. The average total hospitalization cost of the cases was 780 TL, and the average daily cost was 135 TL. With these data, SSTI is a frequently seen phenomenon in CHD clinical practice is the disease; It would be appropriate to consider this situation and to include it in the training program. In addition, optimal outpatient treatment of patients can reduce hospitalization. As a result; SSTI is common, and antibiotic treatment by the first-time physician may reduce hospitalization.