Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center
AbstractBackground: Paediatric acute hematogenous osteomyelitis (AHOM) is a serious disease requiring early diagnosis and treatment. To review the clinical presentation, management and organisms responsible for AHOM, and to explore risk factors for complicated AHOM, a large cohort referring to a single center over a 6-year period was evaluated. Methods: Data from children with AHOM, hospitalized between 2010 and 2015, and aged > 1 month, were retrospectively collected and analyzed. Results: 121 children (median age 4.8 years; 55.4% males) were included. Fever at onset was present in 55/121 children (45.5%); the lower limb was most frequently affected (n = 68/121; 56.2%). Microbiological diagnosis (by culture and/or polymerase chain reaction (PCR)) was reached in 33.3% cases. Blood and pus/biopsy culture sensitivities were 32.4% and 46.4%, respectively. PCR sensitivity was 3.6% (2/55) on blood, and 66.6% (16/24) on pus/biopsy sample. Staphylococcus aureus was the most commonly identified pathogen (n = 20); no methicillin-resistant Staphylococcus aureus (MRSA) was isolated, 10.0% (n = 2) strains were Panton-Valentine-Leukocidin (PVL) producer; 48.8% (59/121) cases were complicated. At univariate analysis, factors associated with complicated AHOM were: recent fever episode, fever at onset, upper limb involvement, white blood count (WBC) ≥ 12,000/µL, C reactive protein (CRP) ≥ 10 mg/L, S. aureus infection. At multivariate analyses S. aureus infection remained the only risk factor for complicated AHOM (aOR = 3.388 (95%CI: 1.061–10.824); p-value = 0.039). Conclusions: In this study microbiological diagnosis was obtained in over one third of cases. Empiric treatment targeting methicillin-sensitive Staphylococcus aureus seems to be justified by available microbiological data. View Full-Text
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Chiappini, E.; Camposampiero, C.; Lazzeri, S.; Indolfi, G.; De Martino, M.; Galli, L. Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center. Int. J. Environ. Res. Public Health 2017, 14, 477.
Chiappini E, Camposampiero C, Lazzeri S, Indolfi G, De Martino M, Galli L. Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center. International Journal of Environmental Research and Public Health. 2017; 14(5):477.Chicago/Turabian Style
Chiappini, Elena; Camposampiero, Caterina; Lazzeri, Simone; Indolfi, Giuseppe; De Martino, Maurizio; Galli, Luisa. 2017. "Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center." Int. J. Environ. Res. Public Health 14, no. 5: 477.
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