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Published on: February 25, 2022
[Osteoarticular infections in children: five-year experience]
Andrea Hänel K1, Pilar Rodríguez2, Antonia Silva B1
1Depto. Pediatría y Cirugía Infantil Sede Sur, Facultad de Medicina, Universidad de Chile, Chile.
Insights
Osteoarticular infections (IOA) are common in boys, with Staphylococcus aureus being the primary pathogen. Early antistaphylococcal beta-lactam treatment is recommended for pediatric patients with IOA.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Osteoarticular infections (IOA) are medical emergencies in children.
- Staphylococcus aureus and Streptococcus pyogenes are the most common causative agents.
Purpose of the Study:
- To characterize demographic and clinical features of pediatric patients hospitalized with IOA between 2012 and 2017.
- To identify common pathogens and treatment outcomes in pediatric IOA.
Main Methods:
- Retrospective analysis of clinical records from a pediatric hospital.
- Inclusion criteria: patients aged 2 months to 15 years with IOA diagnosis.
- Data collected included demographics, symptoms, microbiological findings, treatment, and outcomes.
Main Results:
- 146 patients met inclusion criteria; 60.3% were male, median age 3 years 11 months.
- Joint pain was the primary symptom (90%); Staphylococcus aureus identified in 67.8% of positive cultures (10.2% MRSA).
- 94.5% received empirical antistaphylococcal beta-lactam treatment; 70.5% underwent surgery. Clinical response within 72 hours, with inflammatory markers decreasing by 4.7 days. 88% had no complications.
Conclusions:
- IOA predominantly affects boys, with S. aureus as the leading pathogen.
- Recommend initiating antimicrobial therapy with an antistaphylococcal beta-lactam.
- Consider adding broad-spectrum antibiotics for children under 5. Clinical and laboratory improvements observed after 5 days of treatment.
Background:
Osteoarticular infections (IOA) are considered infectious emergencies. The main microorganisms isolated are Staphylococcus aureus and Streptococcus pyogenes.
Aim:
To describe demographic and clinical characteristics of patients from 2 months to 15 years old, hospitalized between the years 2012 and 2017 with IOA diagnosis.
Methods:
Retrospective study in a pediatric hospital. Clinical records of hospitalized patients with IOA were reviewed.
Results:
146 met inclusion criteria. 60.3% of the patients were male, median age 3 years 11 months. The main symptom at admission was joint pain (90%) and the median CRP was 43 mg/L. 48% of the patients had microbiological identification; 67.8% were positive for Staphylococcus aureus (10.2% SAMR). 94.5% of the sample received empirical antistaphylococcal beta-lactam treatment and 70,5% had a surgical intervention. Clinical response was observed 72 hours of beginning of treatment, and a decreased in inflammatory laboratory markers was observed at 4.7 days. 88% of patients attended without complications.
Conclusions:
IOA infections are more common in boys, S. aureus is the main isolated pathogen, so we suggest to initiate the antimicrobial scheme with an antistaphylococcal beta-lactam, adding broad spectrum antimicrobial in children under 5 years. After 5 days of treatment, clinical resolution and decreased inflammatory laboratory parameters were observed.
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