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Published on: February 9, 2011
The changing epidemiology of acute and subacute haematogenous osteomyelitis in children
M J Blyth1, R Kincaid, M A Craigen
1Department of Orthopaedics and Trauma, Royal Hospital for Sick Children, Glasgow, Scotland, UK.
Insights
Acute osteomyelitis incidence in children has significantly decreased by 44% in Greater Glasgow. This trend, with Staphylococcus aureus as the main pathogen, indicates childhood osteomyelitis is becoming a rare disease.
Area of Science:
- Pediatric infectious diseases
- Epidemiology of bone infections
Background:
- Acute haematogenous osteomyelitis (AHO) is a serious bone infection in children.
- Previous studies indicated a decline in AHO incidence between 1970 and 1990.
Purpose of the Study:
- To review the incidence of acute and subacute osteomyelitis in children under 13 in Greater Glasgow from 1990 to 1997.
- To analyze trends and identify causative pathogens and outcomes.
Main Methods:
- Retrospective review of bacteriologically or radiologically confirmed cases.
- Statistical analysis including multiple regression to assess incidence trends over 28 years.
Main Results:
- A 44% fall in AHO incidence observed between 1990-1997 (p=0.005), mirroring earlier declines.
- Staphylococcus aureus was the most common pathogen (70%).
- Low rates of surgery (20%) and complications (10%) were noted; subacute cases had benign courses.
Conclusions:
- Childhood osteomyelitis incidence has significantly declined in the Greater Glasgow area.
- The disease is becoming rare, with an annual incidence of 2.9 cases per 100,000 population.
- Staphylococcus aureus remains the primary pathogen, with favorable outcomes for most patients.
Abstract:
We have reviewed the incidence of bacteriologically or radiologically confirmed acute haematogenous osteomyelitis in children under 13 years of age resident in the area of the Greater Glasgow Health Board between 1990 and 1997. In this period there was a fall of 44% in the incidence of both acute and subacute osteomyelitis, mainly involving the acute form (p = 0.005). This mirrors the decline of just over 50% previously reported in the same population between 1970 and 1990. Using multiple regression analysis a decline in incidence of 0.185 cases per 100,000 population per year was calculated for the 28-year period (p < 0.001). Staphylococcus was the most commonly isolated pathogen (70%). Only 20% of patients required surgery and there was a low rate of complications (10%). In general, patients with a subacute presentation followed a benign course and there were no complications or long-term sequelae in this group. Haematogenous osteomyelitis in children in this area is becoming a rare disease with an annual incidence of 2.9 new cases per 100,000 population per year.
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