Microbiological profile of haematogenous osteoarticular infections in children

Orthop Traumatol Surg Res. 2011 Apr;97(2):186-90. doi: 10.1016/j.otsr.2010.10.005. Epub 2011 Mar 2.

Abstract

Introduction: Staphylococcus aureus, Kingella kingae and β-hemolytic streptococcus are presently the most frequently identified bacteria in child haematogenous osteoarticular infection.

Objective: To determine the microbiological profile (bacteria and antibiotic susceptibility) of osteoarticular infections in a paediatric hospital, so as to adapt treatment protocols to the ecology of the bacteria isolated.

Patients and methods: Prospective descriptive study, including children admitted for acute osteomyelitis or septic arthritis. A series of blood cultures was performed systematically on admission. In case of surgery, local samples were taken for bacteriology. Antibiotherapy was initiated and subsequently adapted to the bacteriological findings.

Results: One hundred and six children were included. Thirty-five were under (Group 1) and 71 over 3 years of age (Group 2). Ninety-five underwent surgery. Peroperative samples were positive in 61 cases and blood culture in 23. Bacteria were isolated in 22 patients in G1. Extended-spectrum β-lactamase-producing Klebsiella pneumoniae was isolated in five neonates who had passed through intensive care. Staphylococcus aureus was the most frequently isolated bacterium in G2 (n=40), and was methicillin-resistant (MRSA) in six children.

Discussion: Methicillin-susceptible Staphylococcus aureus was the most frequently isolated microorganism. Other than neonates who had passed through intensive care and the six patients with community-acquired MRSA infection, all isolated bacteria were susceptible to second-generation cephalosporins.

Level of evidence: II, prospective descriptive prognostic study.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Arthritis, Infectious / drug therapy
  • Arthritis, Infectious / microbiology*
  • Arthritis, Infectious / surgery
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / microbiology*
  • Klebsiella Infections / surgery
  • Klebsiella pneumoniae / isolation & purification
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Osteomyelitis / drug therapy
  • Osteomyelitis / microbiology*
  • Osteomyelitis / surgery
  • Prospective Studies
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / microbiology*
  • Staphylococcal Infections / surgery

Substances

  • Anti-Bacterial Agents