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Published on: December 31, 2017
Community-acquired bone and joint infections in children: a 1-year prospective epidemiological study
Ayoub Mitha1, Nathalie Boutry2, Eric Nectoux3
1Lille-2 University, University of Lille Nord-de-France, Lille, France Paediatric Emergency Unit and Infectious Diseases, Lille Nord-de-France University Hospital, CHRU Lille, Lille, France.
Insights
The incidence of childhood bone and joint infections (BJIs) is 7.1 per 100,000 children. This study determined the incidence and characteristics of BJIs in previously well children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- The incidence of childhood bone and joint infections (BJIs) is not well established.
- Understanding BJI incidence is crucial for epidemiological insights and practice improvement.
Purpose of the Study:
- To ascertain the incidence of BJIs in previously healthy children.
- To characterize the clinical, laboratory, and radiological features of pediatric BJIs.
Main Methods:
- A multicenter, population-based prospective study was conducted in northern France from July 2008 to June 2009.
- A capture-recapture method, utilizing a prospective database and discharge summaries, was employed to calculate the corrected incidence of BJIs.
- Diagnoses of septic arthritis, acute osteomyelitis, and spondylodiscitis were confirmed using consensus criteria and blinded radiological review.
Main Results:
- The study identified 58 cases of BJI in children under 16 years old.
- The corrected incidence of any BJI was 7.1 per 100,000 children. Septic arthritis occurred in 52% and osteomyelitis in 41% of cases.
- Staphylococcus aureus was the most frequently identified pathogen, and characteristic radiological findings were present in 44% of BJIs.
Conclusions:
- The corrected incidence of childhood bone and joint infections (BJIs) in northern France was determined to be 7.1 per 100,000 children under 16.
- This incidence was established using consensus diagnostic criteria, highlighting the epidemiological burden of BJIs in this pediatric population.
Background:
The incidence of childhood bone and joint infections (BJIs) is not well known, but is useful for identifying epidemiological differences and improving practice.
Objective:
To determine the incidence of BJI in previously well children and describe their clinical, laboratory and radiological characteristics.
Design:
A multicentre, population-based, prospective study performed from July 2008 through June 2009.
Setting:
Region of northern France with a population of 872 516 children <16 years old.
Patients:
All previously well children admitted in the region with septic arthritis, acute osteomyelitis or spondylodiscitis, diagnosed according to consensus criteria and after blinded radiological review.
Main Outcome Measures:
The corrected incidence of BJI, determined with a capture-recapture method that used this prospective database and the discharge summary database.
Results:
58 cases were identified (median age: 3.6 years, range: 1 month-15.8 years; male to female ratio: 1.6). The completeness of the prospective database was 90%. The corrected incidence of any BJI was 7.1/100 000 children (95% CI 5.3 to 8.9). Thirty patients had septic arthritis (52%, incidence: 3.7/100 000; 95% CI 2.4 to 4.9), 24 osteomyelitis (41%, incidence 3.0/100 000; 95% CI 1.8 to 4.1), 4 spondylodiscitis (7%) and 0 osteoarthritis. Micro-organisms were identified from 15 patients (26%), with Staphylococcus aureus the most frequent organism. Radiological findings were characteristic of infection in 44% of BJI.
Conclusions:
The corrected incidence of BJI in northern France, according to consensus diagnostic criteria, was 7.1/100 000 children <16 years of age.
