Microbiological characteristics of acute osteoarticular infections in children.

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 68 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 WCC but elevated CRP and/or ESR. Bacteraemia was associated with a longer average length of hospitalisation 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% 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. PMID: 25596125 [PubMed - as supplie...
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research