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Osteoarticular infections in infants under 3 months of age

Joana Branco1, Mariana Duarte1, Susana Norte2

  • 1Infectious Diseases Unit, Hospital de Dona Estefânia, CHULC - EPE, Lisbon, Portugal.

Pediatrics International : Official Journal of the Japan Pediatric Society
|August 8, 2022
PubMed

Insights

Acute osteoarticular infections (OAI) in infants under 3 months are challenging to diagnose and lead to more complications. Multidrug-resistant bacteria, particularly Staphylococcus aureus, are a significant concern in these young patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Orthopedic Infections
  • Neonatal Care

Background:

  • Acute osteoarticular infections (OAI) in infants under 3 months (≤3M) are rare but pose diagnostic challenges.
  • Orthopedic complications and functional sequelae in this age group are not well-described.
  • Understanding trends in OAI etiology, management, and outcomes in infants ≤3M is crucial.

Purpose of the Study:

  • To evaluate trends in etiology, management, and outcomes of OAI in infants ≤3M.
  • To compare OAI in infants ≤3M with that in older children.
  • To identify factors associated with complications and sequelae in OAI ≤3M.

Main Methods:

  • A longitudinal observational study of OAI cases admitted to a tertiary care pediatric hospital from 2008 to 2018.
  • Comparison of OAI cases in infants ≤3M with those in children >3 months.
  • Analysis of clinical, microbiological, imaging, and outcome data.

Main Results:

  • 24 OAI cases (9.1%) were identified in infants ≤3M, with a twofold increase since 2014.
  • Staphylococcus aureus (57.1%) and Group B Streptococcus (23.8%) were the most common pathogens; 25% were multidrug-resistant.
  • OAI ≤3M cases showed higher rates of bacteremia, multidrug-resistant bacteria, healthcare-associated infections, complications, and sequelae (17.4%) compared to older children.

Conclusions:

  • Staphylococcus aureus remains the primary cause of OAI in infants ≤3M.
  • A significant proportion (25%) of causative bacteria in OAI ≤3M are multidrug-resistant.
  • Infants ≤3M with OAI experience more frequent complications and sequelae than older children.
Abstract

Keywords:
Staphylococcus aureusinfantnewbornosteoarticular infection

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