Needle Aspiration for the Etiologic Diagnosis of Children With Cellulitis in the Era of Community-Acquired Methicillin-Resistant Staphylococcus aureus

Abstract

Objective: Cellulitis is a common problem in children but determining the causative agent is difficult. One tool used to identify the etiology is needle aspiration. The purpose of this study was to determine the utility of needle aspiration in pediatric patients with cellulitis in the era of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Methods: This was a prospective descriptive study conducted in the emergency department of a tertiary care children’s hospital. A convenience sample of healthy children, 0 to 18 years old, with cellulitis were enrolled. A standard cellulitis aspiration technique was performed. Results: Twenty patients were enrolled and had cultures obtained. The etiologic agent was determined in 15% (3/20) of patients. The positive cultures were all MRSA. Conclusions: Although needle aspiration of cellulitis was of low yield, the only pathogens isolated in this study were CA-MRSA. Empiric antibiotics for cellulitis should include coverage for MRSA. In circumstances in which bacterial etiology and antibiotic susceptibility knowledge would be critical, needle aspiration should be considered.