[Epidemiology and bacteriological diagnosis of paediatric acute osteoarticular infections]

Area of Science:

• Pediatric Infectious Diseases
• Microbiology
• Molecular Diagnostics

Background:

• Acute pediatric osteo-articular infections necessitate rapid and sensitive diagnosis for targeted treatment.
• Staphylococcus aureus and Kingella kingae are the predominant pathogens, with K. kingae being the leading cause of septic arthritis in children under three.
• Other pathogens include hemolytic Streptococci and Streptococcus pneumoniae, while oxacillin-resistant S. aureus remains infrequent in France.

Purpose of the Study:

• To highlight the importance of timely diagnosis in pediatric osteo-articular infections.
• To emphasize the diagnostic utility of Polymerase Chain Reaction (PCR) for identifying key pathogens.
• To discuss current diagnostic approaches for septic arthritis and osteomyelitis in children.

Main Methods:

• Analysis of synovial fluid from affected joints for microbiological diagnosis of septic arthritis.
• Systematic inoculation of blood culture vials to enhance K. kingae recovery.
• Implementation of universal or targeted PCR assays when initial cultures are negative.
• Reliance on blood cultures for diagnosing acute osteomyelitis, as bone puncture is not routine.

Main Results:

• Kingella kingae is a prevalent cause of septic arthritis in young children.
• PCR testing offers significant benefits for diagnosing pediatric septic arthritis, especially for K. kingae DNA detection.
• Blood cultures have low efficiency for osteomyelitis diagnosis, necessitating complementary diagnostic strategies.

Conclusions:

• Accurate and prompt diagnosis of pediatric osteo-articular infections is essential for effective management.
• PCR is a valuable tool, particularly for detecting K. kingae in pediatric septic arthritis.
• Improved diagnostic methods are needed for acute osteomyelitis, considering the limitations of blood cultures.