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The Contemporary Microbiology and Rates of Concomitant Osteomyelitis in Acute Septic Arthritis
- Source :
- Pediatric Infectious Disease Journal. 36:267-273
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Septic arthritis (SA) and acute osteomyelitis (AO) are among the most common serious bacterial infections of childhood. Knowledge of the microbiology of SA is critical to treatment. Awareness of the presence of attendant AO is also important to guide clinical management. We sought to describe the current microbiology of SA in children and clinical features associated with coexisting AO.Patients with SA were identified from the infectious diseases consult service records from 2010 to 2014. Patients with penetrating/open trauma and orthopedic hardware in situ were excluded.A total of 168 patients with SA were included. The most common causative organism was Staphylococcus aureus accounting for 47.7% of cases (29.1% were methicillin-susceptible S. aureus and 18.5% were methicillin-resistant S. aureus), followed by group A streptococcus (GAS, 8.9%). The proportion of cases due to GAS increased from 2011 to 2014 (3.3%-16.7%; P = 0.1). One hundred eight (64.3%) patients had concurrent AO. The presence of osteomyelitis was associated with older median age (5.9 vs. 2.4 years; P = 0.04), a longer duration of symptoms (5 vs. 2.5 days; P0.001), S. aureus (62.1% vs. 21.7%; P0.001), bacteremia (46.2% vs. 20.3%; P = 0.001), a longer duration of fever after admission (5 vs. 2 days; P0.001) and a longer length of stay (10 vs. 6 days; P0.001).Methicillin-resistant S. aureus continues to be an important cause of SA though GAS may be increasing in frequency. The presence of concomitant osteomyelitis is higher than previously reported and associated with older age, a longer duration of symptoms and fever, bacteremia and S. aureus.
- Subjects :
- Male
Methicillin-Resistant Staphylococcus aureus
Microbiology (medical)
Arthritis
Bacteremia
medicine.disease_cause
Microbiology
03 medical and health sciences
0302 clinical medicine
Infectious Epidemiology
030225 pediatrics
medicine
Humans
Child
Retrospective Studies
Arthritis, Infectious
030222 orthopedics
Acute osteomyelitis
business.industry
Osteomyelitis
Infant
Retrospective cohort study
Staphylococcal Infections
medicine.disease
Methicillin-resistant Staphylococcus aureus
Infectious Diseases
Child, Preschool
Concomitant
Pediatrics, Perinatology and Child Health
Female
Septic arthritis
business
Subjects
Details
- ISSN :
- 08913668
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Pediatric Infectious Disease Journal
- Accession number :
- edsair.doi.dedup.....20c5ae4aec4c06beda6f9eb56836a5b3