Elena Chiappini1, Andrzej Krzysztofiak2, Elena Bozzola2, Clara Gabiano3, Susanna Esposito4, Andrea Lo Vecchio5, Maria Rita Govoni6, Cristina Vallongo7, Icilio Dodi8, Elio Castagnola9, Nadia Rossi10, Piero Valentini11, Fabio Cardinale12, Filippo Salvini13, Gianni Bona14, Grazia Bossi15, Alma Nunzia Olivieri16, Fiorella Russo17, Emilio Fossali18, Gabriella Bottone19, Marta Dellepiane3, Maurizio De Martino1, Alberto Villani2, Luisa Galli1. 1. a Department of Health Sciences, Paediatric Infectious Diseases Unit, Department of Paediatric Medicine , Anna Meyer Children's University Hospital , Firenze , Italy. 2. b University and Hospital Pediatric Department, Pediatric and Infectious Disease Unit , Children Hospital Bambino Gesù , Rome , Italy. 3. c Department of Public Health and Pediatric Sciences , University of Turin, Pediatric Unit, Regina Margherita Children's University Hospital , Turin , Italy. 4. d Pediatric Clinic, Department of Surgical and Biomedical Sciences , University of Studies of Perugia , Perugia , Italy. 5. e Department of Translational Medical Sciences - Section of Pediatrics, Pediatric Infectious Diseases Unit , University of Naples Federico II , Naples , Italy. 6. f Department of Reproduction and Growth , St. Anna Hospital , Ferrara , Italy. 7. g Department of Pediatrics , "Dell'Angelo" Hospital , Verona , Italy. 8. h Department of Pediatrics , Parma University Hospital , Parma , Italy. 9. i IRCCS Giannina Gaslini , Infectious Diseases Unit , Genua , Italy. 10. j Department of Child and Maternal Health, Pediatric Clinic , "Ss. Annunziata Hospital" , Chieti , Italy. 11. k Institute of Pediatrics , Catholic University of Sacred Heart, Gemelli Hospital , Rome , Italy. 12. l Department of Pediatrics and Respiratory Allergies , Giovanni XXIII Pediatric Hospital , Bari , Italy. 13. m Department of Pediatrics , University of Milan- ASST Santi Paolo e Carlo , Milan , Italy. 14. n Pediatric Division , "Maggiore Carità" Hospital, University of Piemonte orientale , Novara , Italy. 15. o Pediatric Clinic , University of Pavia, IRCCS Policlinico "S. Matteo" Foundation , Pavia , Italy. 16. p Department of Woman, Child, and General and Specialistic Surgery , Second University of Studies of Naples , Naples , Italy. 17. q Desio Hospital , Pediatrics and Neonatology Unit , Desio , Italy. 18. r Pediatric Emergency Unit , Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milan , Italy. 19. s Department of Internal Medicine and Public Health , University of L'Aquila , L'Aquila , Italy.
Abstract
BACKGROUND: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae. METHODS: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged >1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed. RESULTS: 300 children with AHOM and 98 with SAHOM were included. Median age was 6.0 years (IQR: 2.0-11.0). No clinical difference was observed with the exception of fever at onset (63.0% vs. 42.9%; P < 0.0001), and a more common spinal involvement in SAHOM (6.7% vs 20.4%; P < 0.001). Fifty-Eight Staphylococcus aureus strains were isolated; 5 (8.6%) were MRSA. No Kingella kingae infection was documented. No different risk for complication/sequela was observed between AHOM and SAHOM (38.3% vs. 34.7%; OR:0.85; 95%CI: 0.53-1.38; P = 0.518). Duration and type of antibiotic therapy were not associated with risk of complication/sequelae. CONCLUSION: AHOM and SAHOM displayed some differences, however occurrence and risk factors for complications and sequelae are similar, and the same empiric treatment might be recommended.
BACKGROUND: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae. METHODS: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged >1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed. RESULTS: 300 children with AHOM and 98 with SAHOM were included. Median age was 6.0 years (IQR: 2.0-11.0). No clinical difference was observed with the exception of fever at onset (63.0% vs. 42.9%; P < 0.0001), and a more common spinal involvement in SAHOM (6.7% vs 20.4%; P < 0.001). Fifty-Eight Staphylococcus aureus strains were isolated; 5 (8.6%) were MRSA. No Kingella kingae infection was documented. No different risk for complication/sequela was observed between AHOM and SAHOM (38.3% vs. 34.7%; OR:0.85; 95%CI: 0.53-1.38; P = 0.518). Duration and type of antibiotic therapy were not associated with risk of complication/sequelae. CONCLUSION: AHOM and SAHOM displayed some differences, however occurrence and risk factors for complications and sequelae are similar, and the same empiric treatment might be recommended.
Authors: Elena Chiappini; Elena Serrano; Luisa Galli; Alberto Villani; Andrzej Krzysztofiak Journal: Int J Environ Res Public Health Date: 2019-09-23 Impact factor: 3.390