Serious skin infections in children: a review of admissions to Gisborne Hospital (2006-2007).

AIM: Serious skin infections are an important and increasing problem in New Zealand children. The highest national rates are in the Tairawhiti (Gisborne) region on the East Coast of New Zealand's North Island, where evidence of significant ethnic disparities exists. This study aimed to describe the characteristics of serious skin infections in children hospitalised in the Tairawhiti region.

METHODS

The hospital charts of all children aged 0-14 years admitted to Gisborne Hospital between 1 January 2006 and 31 December 2007 for a serious skin infection were retrospectively reviewed and data on a range of variables analysed.

RESULTS

There were 163 cases of serious skin infections during the study period with 83% occurring in Maori children. The most common types of infection were cellulitis (38%) and subcutaneous abscesses (36%), and the most frequent sites of infection were the head, face and neck (32%) and lower limbs (32%). A previous episode of skin infection was recorded in 34% of children, with previous hospitalisation in 12%. A skin injury preceded infection in 37% of cases, more than reported in the Auckland and Wellington regions. Of the 77% of children who saw a GP 60% required immediate hospital admission. Compared with figures from the Auckland region, there were longer delays to medical care with a mean duration of symptoms of 2.5 days prior to visiting a GP. The most frequently isolated organisms were Staphylococcus aureus (48%) and Streptococcus pyogenes (20%) with similar proportions and resistance patterns to other New Zealand settings.

CONCLUSIONS

The characteristics of serious skin infections in the Tairawhiti region are largely similar to those reported in other New Zealand regions. However, some differences in preceding skin injuries and delays in seeking medical care exist which may contribute to the high incidence of hospitalised infections in the region. These differences require further investigation.