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12:18
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Acute osteomyelitis and septic arthritis in children
E D Goergens1, A McEvoy, M Watson
1Department of Orthopaedic Surgery, The Children's Hospital at Westmead, New South Wales, Australia.
Journal of Paediatrics and Child Health
|January 27, 2005
Summary
Staphylococcus aureus is the leading cause of pediatric osteomyelitis and septic arthritis post-Hib vaccine. Current Australian antibiotic guidelines are supported, but community-acquired MRSA should be considered in high-risk groups.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Infections
- Vaccinology
Background:
- The Haemophilus influenzae type B (Hib) vaccine has significantly reduced Hib infections.
- Understanding current pathogens and management of acute haematogenous osteomyelitis (AHO) and septic arthritis (SA) is crucial in the post-Hib vaccine era.
Purpose of the Study:
- To review the clinical presentation, management, and causative organisms of AHO and SA in children in Australia after the Hib vaccine.
- To evaluate the appropriateness of current Australian antibiotic guidelines for these conditions.
Main Methods:
- A retrospective chart review was conducted on children under 16 years old admitted between January 1998 and July 2002.
- Patients with ICD discharge codes for AHO or SA were included.
Main Results:
- Staphylococcus aureus was the most common organism (76% of AHO, 39% of SA).
- Methicillin-resistant S. aureus (MRSA) accounted for 9% of AHO and 6% of SA cases.
- Haemophilus influenzae and Kingella kingae were not identified as causative agents.
Conclusions:
- Staphylococcus aureus remains the primary pathogen for AHO and SA in children.
- Current Australian antibiotic guidelines recommending flucloxacillin are supported, with consideration for community-acquired MRSA in specific populations.
- Hib is no longer a common cause of septic arthritis in vaccinated children.
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