Microbiological characteristics of acute osteoarticular infections in children
| Autor: | Mark S. Gaston, Alastair Murray, Clark D Russell, Rishi Ramaesh, Pota Kalima |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Pediatrics Adolescent Bacteremia medicine.disease_cause Microbiology Internal medicine medicine Humans Child Retrospective Studies Arthritis Infectious Bacteria medicine.diagnostic_test business.industry Osteomyelitis Infant Newborn Infant Retrospective cohort study Bacterial Infections General Medicine medicine.disease Confidence interval Staphylococcus aureus Child Preschool Meta-analysis Erythrocyte sedimentation rate Female Septic arthritis business |
| Zdroj: | Journal of Medical Microbiology. 64:446-453 |
| ISSN: | 1473-5644 0022-2615 |
| Popis: | This study aimed to describe the microbiological characteristics of acute septic arthritis (SA) and osteomyelitis (OM) in children. Cases of children (0–15 years) with SA/OM were identified through a retrospective search of hospital discharge codes over a six-year period. In addition, a systematic literature search and meta-analysis of studies reporting culture results of children with SA/OM was performed. In our retrospective chart review, we identified 65 cases of OM and 46 cases of SA. The most frequently cultured organisms in both conditions were Gram-positive cocci, primarily Staphylococcus aureus. On admission, most patients had a normal white blood cell count (WCC) but elevated C-reactive protein (CRP) and/or erythrocyte sedimentation rate (ESR). Bacteraemia was associated with a longer mean length of hospitalization for both infections. Considering our results and the meta-analysis, we found low rates of culture-positivity in cases of clinically confirmed infection. In SA, articular fluid was culture-positive in 42.49 % [95 % confidence interval (CI) 28.39–57.23]. In OM, intra-operative samples were culture-positive in 52.65 % (95 % CI 30.54–74.22). Bacteraemia was detected in 23.91 % (95 % CI 8.40–44.24) of children with SA and 21.48 % (95 % CI 10.89–34.47) with OM. Despite appropriate sampling, a positive microbiological diagnosis is often lacking in paediatric acute osteoarticular infection using standard culture-based methods. This highlights the need for validation and use of more sensitive diagnostic methods, such as PCR. |
| Databáze: | OpenAIRE |
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