Bacterial aetiology of acute osteoarticular infections in children
Bacterial aetiology of acute osteoarticular infections in children
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DOI：
10.1080/08035250410023278
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发表时间：
2005-04-01
期刊：
影响因子：
3.8
通讯作者：
Ferroni, A
中科院分区：
文献类型：
--
作者：
Moumile, K;Merckx, J;Ferroni, A
目的：研究儿童急性骨关节感染的细菌病原学并分析培养方法的有效性。方法：回顾性分析1999年至2002年骨外科住院的406名儿童的407例临床疑似骨关节感染病例的细菌学资料。结果：临床标本细菌培养阳性 74 例（18%）：化脓性关节炎 38 例，骨感染（骨炎、骨髓炎或骨关节炎）36 例。与使用标准固体培养基相比，使用液体培养基瓶从关节液中培养细菌可提高阳性培养率 (p=0.0001)。最常见的病原体是金黄色葡萄球菌（44%），其次是金氏金氏菌（14%）、化脓性链球菌（10%）和肺炎链球菌（10%）。金黄色葡萄球菌最常见于 36 个月以下的儿童 (p=0.0003)，而金黄色葡萄球菌最常见于 36 个月以上的儿童 (p=0.0015)。结论：通过改进培养方法，我们观察到金黄色葡萄球菌的分离复发，但金黄色葡萄球菌仍然是儿童骨关节感染中分离出的主要病原体。这一发现对于适应这些感染的概率抗生素治疗是有用的。
Aim: To study the bacterial aetiology of acute osteoarticular infections in children and to analyse the efficiency of culture methods. Methods: Bacteriological data of 407 cases of clinically suspected osteoarticular infections affecting 406 children hospitalized in an orthopaedic surgery department between 1999 and 2002 were retrospectively reviewed. Results: Bacterial cultures from clinical specimens were positive in 74 cases (18%): 38 cases of septic arthritis and 36 cases of bone infections (osteitis, osteomyelitis or osteoarthritis). The use of liquid medium bottles to grow bacteria from articular fluids increased the rate of positive cultures compared to the use of standard solid media (p=0.0001). The most commonly recovered pathogen was Staphylococcus aureus (44%) followed by Kingella kingae (14%), Streptococcus pyogenes (10%) and Streptococcus pneumoniae (10%). K kingae was most frequently isolated among children under 36 mo of age (p=0.0003), whereas S. aureus was most frequently isolated among children over 36 mo (p=0.0015).Conclusion: By improving our culture method, we observed a recrudescence of isolation of K kingae, but S. aureus remains the main pathogen isolated from osteoarticular infections in children. This finding is useful for the adaptation of a probabilistic antibiotic treatment of these infections.