Clinical Epidemiology and Outcomes of Pediatric Musculoskeletal Infections
dc.contributor.author | Yi, Jumi | |
dc.contributor.author | Wood, James B. | |
dc.contributor.author | Creech, C. Buddy | |
dc.contributor.author | Williams, Derek | |
dc.contributor.author | Jimenez-Truque, Natalia | |
dc.contributor.author | Yildirim, Inci | |
dc.contributor.author | Sederdahl, Bethany | |
dc.contributor.author | Daugherty, Michael | |
dc.contributor.author | Hussaini, Laila | |
dc.contributor.author | Munye, Mohamed | |
dc.contributor.author | Tomashek, Kay M. | |
dc.contributor.author | Focht, Christopher | |
dc.contributor.author | Watson, Nora | |
dc.contributor.author | Anderson, Evan J. | |
dc.contributor.author | Thomsen, Isaac | |
dc.contributor.department | Pediatrics, School of Medicine | |
dc.date.accessioned | 2023-07-31T16:32:07Z | |
dc.date.available | 2023-07-31T16:32:07Z | |
dc.date.issued | 2021 | |
dc.description.abstract | Objectives: To understand the epidemiology of acute hematogenous osteomyelitis and septic arthritis, including clinical and demographic features, microbiology, treatment approaches, treatment-associated complications, and outcomes. Study design: Retrospective cohort study of 453 children with acute hematogenous osteomyelitis and/or septic arthritis from 2009 to 2015. Results: Among the 453 patients, 218 (48%) had acute hematogenous osteomyelitis, 132 (29%) had septic arthritis, and 103 (23%) had concurrent acute hematogenous osteomyelitis/septic arthritis. Treatment failure/recurrent infection occurred in 41 patients (9%). Patients with concurrent acute hematogenous osteomyelitis/septic arthritis had longer hospital stays, longer duration of antibiotic therapy, and were more likely to have prolonged bacteremia and require intensive care. Staphylococcus aureus was identified in 228 (51%) patients, of which 114 (50%) were methicillin-resistant S aureus. Compared with septic arthritis, acute hematogenous osteomyelitis and concurrent acute hematogenous osteomyelitis/septic arthritis were associated with higher odds of treatment failure (OR, 8.19; 95% CI, 2.02-33.21 [P = .003]; and OR, 14.43; 95% CI, 3.39-61.37 [P < .001], respectively). The need for more than 1 surgical procedure was also associated with higher odds of treatment failure (OR, 2.98; 95% CI, 1.18-7.52; P = .021). Early change to oral antibiotic therapy was not associated with treatment failure (OR, 0.64; 95% CI, 0.24-1.74; P = .386). Most (73%) medically attended treatment complications occurred while on parenteral therapy. Conclusions: Musculoskeletal infections are challenging pediatric infections. S aureus remains the most common pathogen, with methicillin-resistant S aureus accounting for 25% of all cases. Concurrent acute hematogenous osteomyelitis/septic arthritis is associated with more severe disease and worse outcomes. Fewer treatment-related complications occurred while on oral therapy. Early transition to oral therapy was not associated with treatment failure. | |
dc.eprint.version | Author's manuscript | |
dc.identifier.citation | Yi J, Wood JB, Creech CB, et al. Clinical Epidemiology and Outcomes of Pediatric Musculoskeletal Infections. J Pediatr. 2021;234:236-244.e2. doi:10.1016/j.jpeds.2021.03.028 | |
dc.identifier.uri | https://hdl.handle.net/1805/34627 | |
dc.language.iso | en_US | |
dc.publisher | Elsevier | |
dc.relation.isversionof | 10.1016/j.jpeds.2021.03.028 | |
dc.relation.journal | The Journal of Pediatrics | |
dc.rights | Publisher Policy | |
dc.source | PMC | |
dc.subject | Anti-bacterial agents | |
dc.subject | Infectious arthritis | |
dc.subject | Gram-negative bacterial infections | |
dc.subject | Gram-positive bacterial infections | |
dc.subject | Osteomyelitis | |
dc.subject | Staphylococcal infections | |
dc.title | Clinical Epidemiology and Outcomes of Pediatric Musculoskeletal Infections | |
dc.type | Article |