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Pediatric osteomyelitis can be caused by anaerobic bacteria, often linked to chronic infections or skin breaches. Identifying these bacteria is crucial for effective treatment, especially with emerging antibiotic resistance.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Orthopedic Surgery
Background:
- Osteomyelitis in children can stem from various etiologic factors.
- Anaerobic bacteria are increasingly recognized as causative agents in pediatric bone infections.
Purpose of the Study:
- To present a series of pediatric osteomyelitis cases caused by anaerobic bacteria.
- To analyze the etiologic factors, microbial profiles, and treatment outcomes.
Main Methods:
- Retrospective review of 26 pediatric patients with anaerobic osteomyelitis.
- Identification of bacterial isolates and assessment of beta-lactamase production.
Main Results:
- Common etiologies included chronic mastoiditis, decubitus ulcers, and sinusitis.
- Predominant anaerobic organisms were anaerobic cocci, Bacteroides sp., and Fusobacterium sp.
- Beta-lactamase-producing organisms were identified in 27% of patients.
Conclusions:
- Anaerobic bacteria are significant pathogens in pediatric osteomyelitis.
- Microbial flora at adjacent mucous surfaces often correlate with causative organisms.
- Awareness of beta-lactamase-producing strains is important for antimicrobial selection.
Abstract:
Twenty-six pediatric patients with osteomyelitis caused by anaerobic bacteria are presented. The etiologic factors were chronic mastoiditis (7 patients), decubitus ulcers (5), chronic sinusitis (4), periodontal abscesses (3), bites (3), paronychia (2), trauma (1) and scalp infection after fetal monitoring (1). Seventy-four organisms (2.8 isolates/specimen), including 63 anaerobes (2.4/specimen), and 11 facultative and aerobic bacteria (0.4/specimen) were recovered. The predominant organisms were anaerobic cocci (29 isolates), Bacteroides sp. (21), Fusobacterium sp. (8), Streptococcus sp. (5) and Clostridium sp. (4). The organisms generally reflected the microbial flora of the mucous surface adjacent to the infected site. Ten beta-lactamase-producing organisms were recovered from 7 (27%) patients. These included all isolates of the Bacteroides fragilis (4) and of Staphylococcus aureus (3), 2 of the 12 Bacteroides melaninogenicus group and 1 of 3 Bacteroides oralis. The clinical, diagnostic and therapeutic aspects of anaerobic osteomyelitis in children are discussed.