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Published on: February 9, 2011
Epidemiology of paediatric pyogenic musculoskeletal infections in a developing country
Sabeel Ahmad1, Sitanshu Barik2, Dipun Mishra3
1Junior Resident, Orthopedics, All India Institute of Medical Sciences, Rishikesh, India.
Insights
This study analyzed pediatric pyogenic musculoskeletal infections in India, finding common pathogens like E. coli and S. aureus. Culture-negative cases showed higher relapse rates, highlighting the need for better detection methods.
Area of Science:
- Pediatric infectious diseases
- Musculoskeletal infections
- Epidemiology in developing countries
Background:
- Limited epidemiological data on pediatric pyogenic musculoskeletal infections in Asia and Africa.
- Factors like malnutrition, delayed treatment, and alternative medicine influence outcomes.
- Need for localized data from tertiary care centers.
Purpose of the Study:
- To retrospectively analyze pediatric pyogenic musculoskeletal infections.
- To identify common pathogens and antibiotic sensitivities.
- To evaluate treatment outcomes and relapse rates in Indian children.
Main Methods:
- Retrospective analysis of patients under 18 years with pyogenic musculoskeletal infections.
- Collection of demographic, clinical, laboratory, and radiological data.
- Analysis of causative organisms, antibiotic susceptibility, surgical interventions, and relapse rates.
Main Results:
- 216 children included; mean age 12.8 years.
- Common pathogens: Escherichia coli (infants), methicillin-sensitive Staphylococcus aureus (children).
- High relapse rate (61%) in culture-negative patients; majority (78.3%) required surgery.
Conclusions:
- Improved pathogen detection methods are crucial for positive culture rates.
- Prospective studies and standardized care protocols are needed.
- Enhancing therapeutic decision-making and prognosis for pediatric musculoskeletal infections.
Background:
Epidemiological data regarding paediatric pyogenic musculoskeletal infections from developing countries of Asia and Africa are sparse and further complicated by the presence of factors like malnutrition, delay in initiating treatment and belief in alternative forms of treatment and under vaccination. The aim of this study is to retrospectively analyse the cases of paediatric pyogenic musculoskeletal infections in a tertiary care centre in India.
Methods:
It is a retrospective study including patients below 18 years of age who had been diagnosed with any pyogenic musculoskeletal infection. Demographic, clinical, laboratory, and radiological details were collected.
Results:
A total of 216 children, with a mean age of 12.8 ± 4.9 years (10 days-18 years), were included in the study. The causative organism could be isolated in 98 cases (45.3%). Escherichia coli and methicillin-sensitive Staphylococcus aureus were the most common pathogens isolated in infants and children, respectively. Imipenem and linezolid were the commonest sensitive antibiotics for children up to 10 years and above 10 years, respectively. Linezolid was the antibiotic of choice in culture-negative cases. The majority (78.3%, n = 169) of children underwent a surgical procedure during the stay at the hospital. A higher relapse rate (61%) was noted in culture-negative patients.
Conclusion:
Improved methods of pathogen detection should be explored to improve the rate of positive cultures. Additional prospective studies with longer patient follow-up and the creation of care protocols are necessary to improve therapeutic decision-making and the prognosis for children with suspected musculoskeletal infection.
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