TY - JOUR
T1 - Osteoarticular Infections in Pediatric Hospitals in Europe
T2 - A Prospective Cohort Study From the EUCLIDS Consortium
AU - Trobisch, Andreas
AU - Schweintzger, Nina A.
AU - Kohlfürst, Daniela S.
AU - Sagmeister, Manfred G.
AU - Sperl, Matthias
AU - Grisold, Andrea J.
AU - Feierl, Gebhard
AU - Herberg, Jethro A.
AU - Carrol, Enitan D.
AU - Paulus, Stephane C.
AU - Emonts, Marieke
AU - van der Flier, Michiel
AU - de Groot, Ronald
AU - Cebey-López, Miriam
AU - Rivero-Calle, Irene
AU - Boeddha, Navin P.
AU - Agapow, Paul Michael
AU - Secka, Fatou
AU - Anderson, Suzanne T.
AU - Behrends, Uta
AU - Wintergerst, Uwe
AU - Reiter, Karl
AU - Martinon-Torres, Federico
AU - Levin, Michael
AU - Zenz, Werner
N1 - Funding Information:
EUCLIDS was funded by the European Union's Seventh Framework Programme (FP7; EC-GA No. 279185). The Austrian node received funding by the Department for Science and Research of the Styrian Federal Government (Austria), GZ: Abt.08-16.K-8/2012-20, and an ESPID grant 2011 for Endowed professorship for pediatric infectious diseases paying particular attention to meningococcal disease at the Department of General Pediatrics of the Medical University of Graz.
Publisher Copyright:
Copyright © 2022 Trobisch, Schweintzger, Kohlfürst, Sagmeister, Sperl, Grisold, Feierl, Herberg, Carrol, Paulus, Emonts, van der Flier, de Groot, Cebey-López, Rivero-Calle, Boeddha, Agapow, Secka, Anderson, Behrends, Wintergerst, Reiter, Martinon-Torres, Levin, Zenz and the EUCLIDS consortium.
PY - 2022/5/4
Y1 - 2022/5/4
N2 - Background: Pediatric osteoarticular infections (POAIs) are serious diseases requiring early diagnosis and treatment. Methods: In this prospective multicenter cohort study, children with POAIs were selected from the European Union Childhood Life-threatening Infectious Diseases Study (EUCLIDS) database to analyze their demographic, clinical, and microbiological data. Results: A cohort of 380 patients with POAIs, 203 with osteomyelitis (OM), 158 with septic arthritis (SA), and 19 with both OM and SA, was analyzed. Thirty-five patients were admitted to the Pediatric Intensive Care Unit; out of these, six suffered from shock, one needed an amputation of the right foot and of four left toes, and two had skin transplantation. According to the Pediatric Overall Performance Score, 36 (10.5%) showed a mild overall disability, 3 (0.8%) a moderate, and 1 (0.2%) a severe overall disability at discharge. A causative organism was detected in 65% (247/380) of patients. Staphylococcus aureus (S. aureus) was identified in 57.1% (141/247) of microbiological confirmed cases, including 1 (0.7%) methicillin-resistant S. aureus (MRSA) and 6 (4.2%) Panton-Valentine leukocidin (PVL)-producing S. aureus, followed by Group A Streptococcus (18.2%) and Kingella kingae (8.9%). K. kingae and PVL production in S. aureus were less frequently reported than expected from the literature. Conclusion: POAIs are associated with a substantial morbidity in European children, with S. aureus being the major detected pathogen. In one-third of patients, no causative organism is identified. Our observations show an urgent need for the development of a vaccine against S. aureus and for the development of new microbiologic diagnostic guidelines for POAIs in European pediatric hospitals.
AB - Background: Pediatric osteoarticular infections (POAIs) are serious diseases requiring early diagnosis and treatment. Methods: In this prospective multicenter cohort study, children with POAIs were selected from the European Union Childhood Life-threatening Infectious Diseases Study (EUCLIDS) database to analyze their demographic, clinical, and microbiological data. Results: A cohort of 380 patients with POAIs, 203 with osteomyelitis (OM), 158 with septic arthritis (SA), and 19 with both OM and SA, was analyzed. Thirty-five patients were admitted to the Pediatric Intensive Care Unit; out of these, six suffered from shock, one needed an amputation of the right foot and of four left toes, and two had skin transplantation. According to the Pediatric Overall Performance Score, 36 (10.5%) showed a mild overall disability, 3 (0.8%) a moderate, and 1 (0.2%) a severe overall disability at discharge. A causative organism was detected in 65% (247/380) of patients. Staphylococcus aureus (S. aureus) was identified in 57.1% (141/247) of microbiological confirmed cases, including 1 (0.7%) methicillin-resistant S. aureus (MRSA) and 6 (4.2%) Panton-Valentine leukocidin (PVL)-producing S. aureus, followed by Group A Streptococcus (18.2%) and Kingella kingae (8.9%). K. kingae and PVL production in S. aureus were less frequently reported than expected from the literature. Conclusion: POAIs are associated with a substantial morbidity in European children, with S. aureus being the major detected pathogen. In one-third of patients, no causative organism is identified. Our observations show an urgent need for the development of a vaccine against S. aureus and for the development of new microbiologic diagnostic guidelines for POAIs in European pediatric hospitals.
KW - EUCLIDS
KW - Europe
KW - pediatric osteomyelitis
KW - pediatric septic arthritis
KW - S. aureus
UR - http://www.scopus.com/inward/record.url?scp=85133305799&partnerID=8YFLogxK
U2 - 10.3389/fped.2022.744182
DO - 10.3389/fped.2022.744182
M3 - Article
AN - SCOPUS:85133305799
SN - 2296-2360
VL - 10
SP - 1
EP - 12
JO - Frontiers in Pediatrics
JF - Frontiers in Pediatrics
M1 - 744182
ER -