Impetigo In Pediatric Population: A Retrospective 6-Year Review

Background Impetigo is the most common skin infection in pediatric age and has the highest incidence increase relative to other skin infections observed in children. The reported incidences in the literature are between 1.65–2.8%, being evident a seasonal variation with peak of incidence during summer and autumn.The aim of this study is to characterize hospitalizations for this pathology in a pediatric population covered by a level II hospital. Methods Observational cohort study on impetigo hospitalizations over a period of 6 years between 2012 and 2017. Demographic data, clinical manifestations, laboratory evaluation, antibiotic therapy, duration of hospitalization and clinical evolution were analyzed. Results During the total of this period, there were 4163 hospitalizations in the Department of Pediatrics, of which 34 (0.8%) for cases of impetigo. Of these cases, 19 (56%) corresponded to bullous impetigo and 15 (44%) to non-bullous. The proportion of impetigo cases at admission ranged from 0% in 2012 to 2013, up to 1.5% of hospital admissions in 2016. Most (94%) were term newborns, 50% male, with a mean age at diagnosis of 12.7 days. Neonatal onphalitis was the most commonly associated pathology in 41%. In only 26% of cases, culture of the pus or bullous fluidwas performed. The most frequent agent was Staphylococcus aureus, identified in 63% of positive cultures. The most used antibiotic therapy (50%) was the association of flucloxacillin with gentamicin. The evolution was favorable, with complete resolution of the clinical manifestations during hospitalization, in all cases. Conclusions Our study shows a demographic, clinical and laboratory characterization coincident with that described in the current literature. The increase in the proportion of hospitalizations due to impetigo over the years raises the possibility that the incidence of the pathology is increasing or that there is an increase in the severity of the cases. These data should be an alert on the possible influence that the adequacy of the care provided to the newborn, bothinside or outside the hospital, may have in terms of public health.