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Osteomyelitis in infants and children. A review of 163 cases
Insights
Pediatric osteomyelitis is often caused by Staphylococcus aureus. Longer antibiotic treatment durations for Staphylococcus aureus osteomyelitis significantly reduced chronic disease development in children.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Osteomyelitis is a common bone infection in children.
- Staphylococcus aureus is a frequent cause of pediatric osteomyelitis.
Purpose of the Study:
- To analyze the epidemiological and etiological characteristics of pediatric osteomyelitis.
- To evaluate treatment outcomes and identify factors influencing chronic disease development.
Main Methods:
- Retrospective review of 163 pediatric osteomyelitis cases over 15 years.
- Identification of causative pathogens, affected bones, and treatment modalities.
- Analysis of treatment duration and its impact on chronic disease.
Main Results:
- Staphylococcus aureus was the primary pathogen (61%).
- The femur, tibia, and humerus were most commonly affected.
- Longer parenteral antibiotic courses ( > 3 weeks) were associated with a lower incidence of chronic disease (2% vs 19%).
Conclusions:
- Staphylococcus aureus is the leading cause of pediatric osteomyelitis.
- Extended antibiotic therapy appears crucial in preventing chronic osteomyelitis in children.
Abstract:
One hundred sixty-three cases of osteomyelitis in infants and children were seen at our hospital during the past 15 years. There were twice as many boys as girls. Staphylococcus aureus was the major etiologic agent, being identified in 61% of the cases. Gram-negative bacteria were responsible for only 14 cases (9%). The femur, the tibia, or the humerus were affected in 103 of the 152 patients with single bone involvement. Ostoemyelitis of more than one bone was seen in 11 cases (7%). Associated joint infectin was confirmed in 29 patients. There were no deaths. Surgical drainage was carried out in 81 cases (50%). Ten patients had recurrent or persistent drainage and one developed a Brodie abscess. Of the patients with S aureus osteomyelitis, chronic disease occurred in 19% of those receiving parenterally administered antibiotics for three weeks or less, but in only one patient (2%) of those who received parenteral antibiotics longer than three weeks.
