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Community-acquired severe staphylococcal septicemia in children: the relationship with blunt trauma
N Güler1, U Oneş, M Yazicioĝlu
1Department of Pediatric Infectious Diseases, Clinical Immunology and Allergy, Faculty of Medicine, Istanbul University, Turkey. Yazicioglu@superonline.com
Insights
Blunt trauma is a significant risk factor for skeletal infections in children with severe staphylococcal septicemia. This type of trauma increases the likelihood of multifocal infections and delayed diagnosis.
Area of Science:
- Pediatric Infectious Diseases
- Trauma Research
- Bacterial Sepsis
Background:
- Investigated the role of blunt trauma in pediatric severe staphylococcal septicemia.
- Focused on community-acquired cases with multi-organ involvement.
- Included 63 previously healthy children over a seven-year period.
Purpose of the Study:
- To establish blunt trauma as a risk factor for severe staphylococcal septicemia in children.
- To determine the association between blunt trauma and skeletal involvement.
- To understand the implications of blunt trauma on infection progression.
Main Methods:
- Retrospective analysis of 63 pediatric patients with severe staphylococcal septicemia.
- Assessed history of blunt trauma (defined as trauma without fracture or obvious wound).
- Compared outcomes, infection sites, and diagnosis times between traumatized and non-traumatized groups.
Main Results:
- Blunt trauma was present in 46% of patients with diagnosed skeletal infections.
- Trauma significantly increased the risk of skeletal infection (odds ratio 15.0, P < 0.001).
- Traumatized patients had higher rates of multi-organ involvement, multifocal skeletal infections, and shorter diagnosis times.
Conclusions:
- Blunt trauma is an important risk factor for skeletal involvement in staphylococcal septicemia.
- Local tissue damage from blunt trauma may facilitate bacterial seeding and multifocal infections.
- Early recognition of blunt trauma history is crucial in managing pediatric staphylococcal septicemia, especially with skeletal involvement.
Background:
With the aim of establishing the role of blunt trauma, a trauma without any fracture or obvious wound, as a risk factor in children who were admitted for community-acquired severe staphylococcal septicemia with various organ involvement, 63 patients were investigated during a seven-year study period. All children were previously healthy.
Results:
Blunt trauma was present in 12 (46%) of 26 septicemic patients in whom skeletal infections were diagnosed and the relative risk of trauma was high (odds ratio 15.0; confidence interval 2.9-75.8, P < 0.001) in these children. Patients with multiple organ involvement and with multifocal skeletal infections were more frequent among traumatized patients. Children with skeletal involvement were significantly older than others (P < 0.001). The period between the first symptom of infection and the diagnosis was shorter in traumatized children (P < 0.001). None of the children with staphylococcal pulmonary or soft tissue infection had any history of trauma. We conclude that blunt trauma is one of the important risk factors for skeletal involvement in staphylococcal septicemia. Its immunosuppressive nature, especially in local damage of the skin barrier, may be the cause of seeding and multifocal infection.