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Decline of bone and joint infections attributable to haemophilus influenzae type b
S G Bowerman1, N E Green, G A Mencio
1Department of Orthopedics, Vanderbilt University Medical Center, Nashville, TN, USA.
Insights
The Haemophilus influenzae vaccine has drastically reduced bone and joint infections in children. This suggests that empiric antibiotic coverage for Haemophilus influenzae may no longer be necessary for treating osteomyelitis and septic arthritis.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Surgery
- Vaccinology
Background:
- Haemophilus influenzae is a significant cause of pediatric septic arthritis and osteomyelitis.
- Widespread vaccination has reduced Haemophilus influenzae meningitis and other invasive infections.
Purpose of the Study:
- To investigate the impact of Haemophilus influenzae vaccination on pediatric bone and joint infections.
- To determine if vaccination has altered the incidence of osteomyelitis and septic arthritis.
Main Methods:
- Retrospective analysis of 165 cases of acute hematogenous osteomyelitis or septic arthritis.
- Comparison of infection incidence before and after the introduction of the Haemophilus influenzae vaccine.
- Data collected from the Department of Orthopaedics at Vanderbilt University.
Main Results:
- The Haemophilus influenzae vaccine has led to a near-zero incidence of related bone and joint infections.
- A significant decline in pediatric osteomyelitis and septic arthritis caused by Haemophilus influenzae was observed post-vaccination.
Conclusions:
- Pediatric vaccination against Haemophilus influenzae is highly effective in preventing bone and joint infections.
- Empiric antibiotic coverage for Haemophilus influenzae may be unnecessary in current pediatric osteomyelitis and septic arthritis management.
Abstract:
Haemophilus influenzae has been a major cause of infectious diseases in children and has been attributed as a significant cause of septic arthritis and osteomyelitis in children. With the advent of widespread vaccination, the incidence of Haemophilus influenzae meningitis and other infections has been well documented. This is thought to be the first report that documents the effect of vaccination on bone and joint infections. One hundred sixty-five cases of acute hematogenous osteomyelitis or septic arthritis treated at the Department of Orthopaedics at Vanderbilt University in the years before and after the advent of the Haemophilus influenzae vaccine to assess whether vaccination affected the incidence of these diseases. The data indicate that the Haemophilus influenzae vaccine has reduced to near 0 the incidence of bone and joint infections because of Haemophilus influenzae. These findings suggest that coverage of Haemophilus influenzae as part of the empiric antibiotic coverage may be no longer needed in the management of acute hematogenous osteomyelitis and septic arthritis in children.