Clinical Spectrum and Microbial Etiology of Bone and Joint Infections in Children: A Retrospective Analysis from...

Area of Science:

• Pediatric Orthopedics
• Infectious Diseases
• Microbiology

Background:

• Acute bone and joint infections are critical emergencies requiring timely intervention to prevent long-term complications like deformities.
• Developing countries need region-specific treatment guidelines, particularly for empiric antibiotic selection, due to unique epidemiological patterns.
• This study addresses the need for local data on pediatric septic arthritis and osteomyelitis in South India.

Approach:

• A retrospective review of electronic medical records was conducted for children (≤12 years) diagnosed with septic arthritis and/or osteomyelitis.
• Data collected included clinical presentation, microbiological findings, treatment duration, and follow-up outcomes.
• Analysis focused on identifying common pathogens, culture positivity rates, and treatment sequelae.

Key Points:

• The study included 207 children, with infections more prevalent in infants (acute) and older children >5 years (chronic).
• Staphylococcus aureus was the predominant organism (71%), with Gram-negative bacteria more common in infants.
• Overall blood and/or wound culture positivity was high at 78%, persisting even after antibiotic treatment in some chronic cases.

Conclusions:

• Early diagnosis and appropriate management of pediatric bone and joint infections are crucial for limb salvage.
• Staphylococcus aureus is the leading cause, but Gram-negative organisms are significant in infants, necessitating tailored empiric antibiotic choices.
• High culture positivity rates underscore challenges in treatment and the need for optimized antibiotic regimens and diagnostic approaches in this region.