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Microbiological characteristics of acute osteoarticular infections in children

Clark D Russell1,2, Rishi Ramaesh1, Pota Kalima1

  • 1Royal Hospital for Sick Children, 9 Sciennes Road, Edinburgh, EH9 1LF, UK.

Journal of Medical Microbiology
|January 18, 2015
PubMed

Insights

Microbiological testing for pediatric septic arthritis and osteomyelitis often yields negative results, even with proper sampling. This indicates a need for more sensitive diagnostic methods like PCR to identify these bone and joint infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Orthopedic Surgery

Background:

  • Acute septic arthritis (SA) and osteomyelitis (OM) are serious pediatric infections.
  • Accurate microbiological diagnosis is crucial for effective treatment and management.

Purpose of the Study:

  • To characterize the microbiological features of pediatric SA and OM.
  • To evaluate the diagnostic yield of standard culture methods in these infections.

Main Methods:

  • Retrospective chart review of pediatric SA/OM cases (0-15 years).
  • Systematic literature search and meta-analysis of culture results.
  • Analysis of white blood cell count (WCC), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR).

Main Results:

  • Staphylococcus aureus was the most common pathogen identified.
  • Elevated CRP and/or ESR were common, while WCC was often normal.
  • Low culture positivity rates were observed: 42.49% for SA joint fluid and 52.65% for OM intra-operative samples.
  • Bacteraemia occurred in 23.91% of SA and 21.48% of OM cases.

Conclusions:

  • Standard culture-based methods frequently fail to provide a microbiological diagnosis in pediatric osteoarticular infections.
  • There is a significant need for more sensitive diagnostic techniques, such as polymerase chain reaction (PCR), to improve detection rates.

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