Browse > Article

The Etiology and Clinical Features of Acute Osteoarthritis in Children; 2003-2009  

Choi, Jin Hyoung (Department of Pediatrics, Seoul National University College of Medicine)
Choe, Young June (Department of Pediatrics, Seoul National University College of Medicine)
Hong, Ki Bae (Department of Pediatrics, Seoul National University College of Medicine)
Lee, Jina (Department of Pediatrics, Seoul National University College of Medicine)
Yoo, Won Joon (Department of Orthopedic Surgery, Seoul National University College of Medicine)
Kim, Han Soo (Department of Orthopedic Surgery, Seoul National University College of Medicine)
Park, Moon Seok (Department of Orthopedic Surgery, Seoul National University College of Medicine)
Cho, Tae Joon (Department of Orthopedic Surgery, Seoul National University College of Medicine)
Chung, Chin Youb (Department of Orthopedic Surgery, Seoul National University College of Medicine)
Lee, Hoan Jong (Department of Pediatrics, Seoul National University College of Medicine)
Choi, In Ho (Department of Orthopedic Surgery, Seoul National University College of Medicine)
Choi, Eun Hwa (Department of Pediatrics, Seoul National University College of Medicine)
Publication Information
Pediatric Infection and Vaccine / v.18, no.1, 2011 , pp. 31-39 More about this Journal
Abstract
Purpose : This study was performed for the purpose of finding causative organisms and clinical features of septic arthritis or acute osteomyelitis in children. Methods : The study involved a retrospective review of the medical records of 63 microbiologically confirmed cases of acute pyogenic arthritis and osteomyelitis. All of the cases were brought about by community-associated infections and managed at the Seoul National University Children's Hospital or Seoul National University Bundang Hospital from June 2003 to July 2009. Results : The median age of all cases was 60 months and there were 35 males and 28 females. Major involved joints included the hip joint (15 cases), knee joint (7 cases), shoulder joint (4 cases), and elbow joint (4 cases). Also, major involved bones included the femur (20 cases), tibia (13 cases), humerus (7 cases), and radius (7 cases). Staphylococcus aureus was the most commonly identified causative organism, accounting for 49 cases (77.8%). Of the 49 isolates of S. aureus, methicillin-resistant S. aureus (MRSA) accounted for 8 cases (16.3%). Group B streptococcus spp. (GBS) and Salmonella spp. accounted for 3 cases, respectively. Nafcillin or cefazolin was often prescribed as an initial empirical antibiotic. There were 9 cases that were managed by a regimen that included vancomycin as the first choice. Fifty four cases (85.7%) recovered without any complications. Methicillin-sensitive S. aureus (MSSA), responsible for 41 cases, caused chronic complications in 3 cases. Of 8 cases caused by MRSA, 1 case showed chronic complication. There were no fatal cases. Conclusion : S. aureus remains the most common organism causing acute pyogenic arthritis and osteomyelitis of childhood acquired in the community. The high prevalence of methicillin resistance among S. aureus should be considered carefully in the selection of initial empirical antibiotics.
Keywords
Osteomyelitis; Arthritis; Pyogenic osteoarthritis; Staphylococcus aureus; Children;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Krogstad P. Osteomyelitis and septic arthritis. In: Feigin RD, Cherry JD, Demmler GJ, Kaplan SL,eds. Textbook of Pediatric Infectious Diseases, 5th ed. W.B Saunders, Philadelphia, 2004;713-36 .
2 Shirtliff ME, Mader JT. Acute septic arthritis. Clin Microbiol Rev 2002;15:527-44.   DOI   ScienceOn
3 Lew DP, Waldvogel FA. Osteomyelitis. Lancet 2004;364:369-79.   DOI   ScienceOn
4 Dormans JP, Drummond DS. Pediatric Hematogenous Osteomyelitis: New trends in presentation, diagnosis, and treatment. J Am Acad Orthop Surg 1994;2:333-41.   DOI
5 Manzotti A, Rovetta L, Pullen C, Catagni MA. Treatment of the late sequelae of septic arthritis of the hip. Clin Orthop Relat Res 2003;410:203-12 .   DOI
6 Korakaki E, Aligizakis A, Manoura A, Hatzidaki E, Saitakis E, Anatoliotaki M, et al. Methicillin-resistant Staphylococcus aureus osteomyelitis and septic arthritis in neonates: diagnosis and management. Jpn J Infect Dis 2007;60:129-31.
7 Shoaib A, Rethnam U, Bansal R, Clay N. The effects of mass immunization on Haemophilus influenzae type B-related orthopaedic disease. J Pediatr Orthop B 2007;16:236-8.   DOI   ScienceOn
8 Goergens ED, McEvoy A, Watson M, Barrett IR. Acute osteomyelitis and septic arthritis in children. J Paediatr Child Health 2005;41:59-62.   DOI   ScienceOn
9 Chong Y, Lee K. Present situation of antimicrobial resistance in Korea. J Infect Chemother 2000;6:189-95.   DOI   ScienceOn
10 Kim HB, Jang HC, Nam HJ, Lee YS, Kim BS, Park WB, et al. In vitro activities of 28 antimicrobial agents against Staphylococcus aureus isolates from tertiary-care hospitals in Korea: a nationwide survey. Antimicrob Agents Chemother 2004;48:1124-7.   DOI   ScienceOn
11 Maltezou HC, Giamarellou H. Community-acquired methicillin-resistant Staphylococcus aureus infections. Int J Antimicrob Agents 2006;27:87-96.   DOI   ScienceOn
12 Fridkin SK, Hageman JC, Morrison M, Sanza LT, Como-Sabetti K, Jernigan JA, et al. Methicillin-resistant Staphylococcus aureus disease in three communities. N Engl J Med 2005;352:1436-44.   DOI   ScienceOn
13 From the Centers for Disease Control and Prevention. Four pediatric deaths from community-acquired methicillin- resistant Staphylococcus aureus --Minnesota and North Dakota, 1997-1999. JAMA 1999;282:1123-5.   DOI   ScienceOn
14 Diederen BM, Kluytmans JA. The emergence of infections with community-associated methicillin resistant Staphylococcus aureus. J Infect 2006;52:157-68.   DOI   ScienceOn
15 Kaplan SL, Hulten KG, Gonzalez BE, Hammerman WA, Lamberth L, Versalovic J, et al. Three-year surveillance of community-acquired Staphylococcus aureus infections in children. Clin Infect Dis 2005;40:1785-91.   DOI   ScienceOn
16 Hussain FM, Boyle-Vavra S, Bethel CD, Daum RS. Current trends in community-acquired methicillin-resistant Staphylococcus aureus at a tertiary care pediatric facility. Pediatr Infect Dis J 2000;19:1163-6.   DOI   ScienceOn
17 Kallen AJ, Driscoll TJ, Thornton S, Olson PE, Wallace MR. Increase in community-acquired methicillin-resistant Staphylococcus aureus at a Naval Medical Center. Infect Control Hosp Epidemiol 2000;21:223-6.   DOI   ScienceOn
18 Klevens RM, Morrison MA, Nadle J, Petit S, Gershman K, Ray S et al. Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007;298:1763-71.   DOI   ScienceOn
19 Welkon CJ, Long SS, Fisher MC, Alburger PD. Pyogenic arthritis in infants and children: a review of 95 cases. Pediatr Infect Dis 1986;5:669-76.   DOI
20 Yuan HC, Wu KG, Chen CJ, Tang RB, Hwang BT. Characteristics and outcome of septic arthritis in children. J Microbiol Immunol Infect 2006;39:342-7.
21 Goergens ED, McEvoy A, Watson M, Barrett IR. Acute osteomyelitis and septic arthritis in children. J Paediatr Child Health 2005;41:59-62.   DOI   ScienceOn
22 Ma SH, Lee YS, Lee SH, Kim HK, Jin JS, Shin EK, et al. Methicillin-resistant Staphylococcus aureus clones with distinct clinical and microbiological features in a Korean community. J Med Microbiol 2007;56:866-8.   DOI   ScienceOn
23 Lunseth PA, Heiple KG. Prognosis in septic arthritis of the hip in children. Clin Orthop 1979;139:81-5.
24 Park CH, Jeong YJ, Choi WJ, Park SB, Kim HS, Kang CM, et al. 4 cases of staphylococcal scalded skin syndrome. Korean J Pediatr 2004;47:106-10.