慢性骨髓炎在儿科的流行病学和管理 - 一个系统的审查
Joan L Robinson1, Deema Gashgarey2, Nourah Alruqaie2
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
PloS one
|December 2, 2025
概括
这项研究审查了关于儿科慢性骨髓炎 (CO) 的证据,发现质量不佳的数据. 虽然金黄色葡萄球菌是一种常见的病原体,但长期服用抗生素似乎无法预防复发.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 儿科医学 儿科医学
背景情况:
- 儿童的慢性骨髓炎 (CO) 可能是骨感染的结果,并导致持久的骨科问题.
- 目前缺乏针对儿科CO的最佳管理指南.
- 这项研究解决了对儿科CO流行病学和治疗的基于证据的理解的需要.
研究的目的:
- 系统地分析有关儿科慢性骨髓炎流行病学的已发表证据.
- 根据现有的文献,评估目前儿童慢性骨髓炎的管理策略.
- 发现研究中的差距,并为未来的高质量研究提供信息.
主要方法:
- 从1989年到2025年,在多个数据库 (Ovid Medline,Embase,CINAHL,Scopus) 中进行了全面的文献搜索.
- 纳入标准侧重于至少两名儿科患者 (17岁以下) 的研究,详细介绍CO流行病学或管理.
- 质量评估评估了管理决策的偏差;研究按国家收入水平分层,提取有关人口统计,病原体,治疗方法和结果的数据.
主要成果:
- 包括41项研究,其中26项来自高收入国家,15项来自低收入国家,分别包括904例和975例.
- 金黄色葡萄球菌是最常见的病原体 (74%的单一病原体病例);骨和股骨最常受到影响.
- 系统性抗生素 (IV/PO) 随后的脱皮是常见的治疗方法,但研究异质性限制了直接比较;没有发现抗生素治疗方案和复发/后续之间有明确的联系.
结论:
- 对儿童慢性骨髓炎的诊断和治疗进行高质量的研究非常需要.
- 经验性抗生素治疗应针对金黄色葡萄球菌.
- 目前的证据不支持使用长时间的抗生素疗程来预防CO复发.
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