{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:48:07Z","timestamp":1790192887104,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>The utility of ancillary testing in improving diagnostic precision or improving patient outcomes in staphylococcal scalded skin syndrome (SSSS) is unclear. Similarly, an optimal antibiotic regimen has yet to be established. Our goal was to describe clinical characteristics and ancillary work\u2010up of SSSS, report bacterial resistance patterns, and examine patient outcomes under varying therapeutic strategies with the aim of developing an evidence\u2010based management algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective review of pediatric patients diagnosed with SSSS at Intermountain Healthcare facilities between 2010 and 2021. A Kruskal\u2013Wallis rank sum test was used to assess median length of stay between different antibiotic regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010five cases were identified. The most common ancillary tests obtained were a complete blood count (88%), followed by chemistry analysis (80%). Blood cultures were collected in more patients (79%) compared to aerobic cultures (60%). No blood culture was positive for\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      . All\n                      <jats:italic>S. aureus<\/jats:italic>\n                      isolates were methicillin\u2010sensitive. Of those found resistant to clindamycin (36%), all demonstrated macrolide\u2010induced clindamycin resistance. None were constitutively resistant to clindamycin. There was no statistical difference between antibiotic regimen and length of stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.691). Receiving opiate medications was the only risk factor associated with prolonged hospitalization (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ancillary testing does not improve diagnostic precision and can be reduced. Clindamycin does not improve patient outcomes, suggesting beta\u2010lactams should be considered first line. Susceptibility patterns in our cohort demonstrate inducible clindamycin resistance as opposed to constitutive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pde.15102","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T18:52:47Z","timestamp":1660675967000},"page":"908-913","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Staphylococcal scalded skin syndrome: Clinical features, ancillary testing, and patient management"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4159-1420","authenticated-orcid":false,"given":"Laurel","family":"Gray","sequence":"first","affiliation":[{"name":"Department of Dermatology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Olson","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease Primary Children's Hospital  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben J.","family":"Brintz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0888-1458","authenticated-orcid":false,"given":"Sarah D.","family":"Cipriano","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Utah  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,16]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"McMahonP.Staphylococcal scalded skin syndrome. Post T ed.UpToDate. UpToDate. Accessed March 23 2022."},{"key":"e_1_2_8_3_1","volume-title":"Dermatology","author":"Bolognia JL","year":"2018"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2018\u20100032"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2021.36.e22"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102133.2011.10515.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13052\u2010021\u201001120\u20106"},{"key":"e_1_2_8_8_1","unstructured":"Committee on Infectious Diseases American Academy of Pediatrics KimberlinDW BarnettED LynfieldR SawyerMH.Staphylococcus aureus. Red Book: 2021\u20132024 Report of the Committee on Infectious Diseases: American Academy of Pediatrics 2021."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3529"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14014"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14629"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.14470"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.12195"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/inf.0000000000002499"},{"key":"e_1_2_8_15_1","volume-title":"R: A Language and Environment for Statistical Computing [program]","year":"2021"},{"key":"e_1_2_8_16_1","volume-title":"Stata Statistical Software: Release 17 [Program]","year":"2021"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000373"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjid.2014.12.011"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.14116"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3181c35cc5"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454\u2010200206000\u201000010"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpids\/piy062"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238991"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0018578718760257"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.15102","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.15102","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.15102","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T03:28:50Z","timestamp":1692588530000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.15102"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,16]]},"references-count":23,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1111\/pde.15102"],"URL":"https:\/\/doi.org\/10.1111\/pde.15102","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,16]]},"assertion":[{"value":"2022-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}