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The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland.

Abstract

OBJECTIVES

To assess the contemporary bacteriologic epidemiology of pediatric osteoarticular infection with particular regard to children's ages, because Kingella kingae has gained increasing recognition as the predominant pathogen for osteoarticular infection in young children.

STUDY DESIGN

Retrospective file review of enrolled children from 0 to 15 years of age, admitted to our institution from 2007 to 2015 for suspected osteoarticular infection (217 cases). Information on age, sex, the bone or joint infected, imaging studies, and laboratory data (including bacterial investigations) were collected for analysis.

RESULTS

Microorganism identification was possible for 138 infected children (63.6%), through blood (cultures or polymerase chain reaction [PCR]) and/or operative samples (cultures or PCR). Thirty-one patients (14.3%) were found to both have positive blood cultures and operative samples. The results of positive bacteriology specimens identified the most common causative pathogen for osteoarticular infection as K kingae (47.8% of microbiologically confirmed osteoarticular infections of all ages, and 87.7% in children between the ages of 6 and 48 months), significantly more common than Staphylococcus aureus (35.5% of microbiologically confirmed osteoarticular infections of all ages, and 78.2% in children >4 years of age).

CONCLUSIONS

Use of the appropriate PCR assays demonstrated that K kingae currently is the major bacterial cause of pediatric osteoarticular infection, especially in children <4 years of age in whom K kingae is more common than S aureus. PCR assays should be used in routine microbiologic laboratory evaluation to improve diagnostic performance. However, despite the use of molecular methods, there are many osteoarticular infections in which no microorganism is detected, which suggests that these infections may be caused by other as yet unrecognized fastidious microorganisms.

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  • Publisher Full Text
  • Authors+Show Affiliations

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    Pediatric Surgery Service, Geneva University Hospitals, Geneva 14, Switzerland.

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    Pediatric Service, Geneva University Hospitals, Geneva 14, Switzerland.

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    Pediatric Service, Geneva University Hospitals, Geneva 14, Switzerland.

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    Department of Radiology, Geneva University Hospitals, Geneva 14, Switzerland.

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    Department of Radiology, Geneva University Hospitals, Geneva 14, Switzerland.

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    Pediatric Emergency Service, Geneva University Hospitals, Geneva 14, Switzerland.

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    Pediatric Orthopedic Service, Geneva University Hospitals, Geneva 14, Switzerland. Electronic address: anne.tabard@hcuge.ch.

    ,

    Pediatric Orthopedic Service, Geneva University Hospitals, Geneva 14, Switzerland.

    Pediatric Orthopedic Service, Geneva University Hospitals, Geneva 14, Switzerland.

    Source

    The Journal of pediatrics 194: 2018 03 pg 190-196.e1

    MeSH

    Adolescent
    Arthritis, Infectious
    Bacterial Infections
    Child
    Child, Preschool
    Female
    Humans
    Infant
    Infant, Newborn
    Male
    Microbiological Techniques
    Osteomyelitis
    Polymerase Chain Reaction
    Retrospective Studies
    Switzerland

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29263015

    Citation

    Juchler, Céline, et al. "The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland." The Journal of Pediatrics, vol. 194, 2018, pp. 190-196.e1.
    Juchler C, Spyropoulou V, Wagner N, et al. The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland. J Pediatr. 2018;194:190-196.e1.
    Juchler, C., Spyropoulou, V., Wagner, N., Merlini, L., Dhouib, A., Manzano, S., ... Ceroni, D. (2018). The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland. The Journal of Pediatrics, 194, pp. 190-196.e1. doi:10.1016/j.jpeds.2017.11.025.
    Juchler C, et al. The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland. J Pediatr. 2018;194:190-196.e1. PubMed PMID: 29263015.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland. AU - Juchler,Céline, AU - Spyropoulou,Vasiliki, AU - Wagner,Noémie, AU - Merlini,Laura, AU - Dhouib,Amira, AU - Manzano,Sergio, AU - Tabard-Fougère,Anne, AU - Samara,Eleftheria, AU - Ceroni,Dimitri, Y1 - 2017/12/18/ PY - 2017/05/22/received PY - 2017/11/01/revised PY - 2017/11/13/accepted PY - 2017/12/22/pubmed PY - 2019/3/21/medline PY - 2017/12/22/entrez KW - Bacteriological epidemiology KW - Kingella kingae KW - Pediatric osteoarticular infection KW - Switzerland SP - 190 EP - 196.e1 JF - The Journal of pediatrics JO - J. Pediatr. VL - 194 N2 - OBJECTIVES: To assess the contemporary bacteriologic epidemiology of pediatric osteoarticular infection with particular regard to children's ages, because Kingella kingae has gained increasing recognition as the predominant pathogen for osteoarticular infection in young children. STUDY DESIGN: Retrospective file review of enrolled children from 0 to 15 years of age, admitted to our institution from 2007 to 2015 for suspected osteoarticular infection (217 cases). Information on age, sex, the bone or joint infected, imaging studies, and laboratory data (including bacterial investigations) were collected for analysis. RESULTS: Microorganism identification was possible for 138 infected children (63.6%), through blood (cultures or polymerase chain reaction [PCR]) and/or operative samples (cultures or PCR). Thirty-one patients (14.3%) were found to both have positive blood cultures and operative samples. The results of positive bacteriology specimens identified the most common causative pathogen for osteoarticular infection as K kingae (47.8% of microbiologically confirmed osteoarticular infections of all ages, and 87.7% in children between the ages of 6 and 48 months), significantly more common than Staphylococcus aureus (35.5% of microbiologically confirmed osteoarticular infections of all ages, and 78.2% in children >4 years of age). CONCLUSIONS: Use of the appropriate PCR assays demonstrated that K kingae currently is the major bacterial cause of pediatric osteoarticular infection, especially in children <4 years of age in whom K kingae is more common than S aureus. PCR assays should be used in routine microbiologic laboratory evaluation to improve diagnostic performance. However, despite the use of molecular methods, there are many osteoarticular infections in which no microorganism is detected, which suggests that these infections may be caused by other as yet unrecognized fastidious microorganisms. SN - 1097-6833 UR - https://www.unboundmedicine.com/medline/citation/29263015/The_Contemporary_Bacteriologic_Epidemiology_of_Osteoarticular_Infections_in_Children_in_Switzerland L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(17)31581-0 DB - PRIME DP - Unbound Medicine ER -