Abstract
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.
Original language | English |
---|---|
Pages (from-to) | 446-53 |
Number of pages | 8 |
Journal | Journal of Medical Microbiology |
Volume | 64 |
Issue number | Pt 4 |
DOIs | |
Publication status | Published - Apr 2015 |
Keywords / Materials (for Non-textual outputs)
- Adolescent
- Arthritis, Infectious
- Bacteremia
- Bacteria
- Bacterial Infections
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Infant, Newborn
- Male
- Osteomyelitis
- Retrospective Studies
- Journal Article
- Meta-Analysis