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Osteoarticular Infections in Infants Under 3 Months of Age

2022Journal article Open access
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dc.contributor.authorBranco, J
dc.contributor.authorDuarte, M
dc.contributor.authorNorte, S
dc.contributor.authorArcangelo, J
dc.contributor.authorAlves, P
dc.contributor.authorBrito, M
dc.contributor.authorTavares, D
dc.contributor.authorGouveia, C
dc.date.accessioned2023-05-04T11:56:49Z
dc.date.available2023-05-04T11:56:49Z
dc.date.issued2022
dc.description.abstractBackground: Acute osteoarticular infections (OAI) in infants under 3 months of age (≤3M) are rare and remain a diagnostic challenge. Orthopedic complications and functional sequelae have been less well described in this age group. Our aims were to evaluate trends in aetiology, management, and outcomes of OAI ≤ 3M, and to compare these younger children who have OAI with older children. Methods: A longitudinal observational study was conducted of OAI cases admitted to tertiary care pediatric hospital from 2008 to 2018. OAI ≤ 3M was compared with children above 3 months. Clinical, microbiological, imaging, and outcome data were analyzed. Results: We identified 24 (9.1%) of the 263 OAI in children under 3 months. Analyzing OAI ≤ 3M there was a twofold increase since 2014; 54% were males with a median age of 28 days (IQR: 13.5-60.0), 10 (41.7%) were premature and nine (37.5%) had healthcare-associated infections. Microbiological causes were identified in 87.5%, mostly Staphylococcus aureus (57.1%) and Group B Streptococcus (23.8%), and 25% were multidrug-resistant (5 methicillin-resistant S. aureus and 1 Enterobacter cloacae). Bacteremia (100% vs 36.8%, P = 0.037), multidrug resistant bacteria (75% vs 16, P = 0.04), and healthcare-associated infections (100% vs 26.3%, P = 0.014) were associated with sequelae. Comparing OAI ≤ 3M with older children, OAI ≤ 3M were treated with longer antibiotic courses, had more complications and sequelae (17.4% vs 3.2%, P = 0.002). Conclusions: S. aureus is still the most common cause of OAI ≤ 3M, and 25% of causative bacteria were multidrug-resistant bacteria. Complications and sequelae were more frequent in OAI ≤ 3M when compared with older children.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationPediatr Int . 2022 Jan;64(1):e15212pt_PT
dc.identifier.doi10.1111/ped.15212pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4508
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectAdolescentpt_PT
dc.subjectAnti-Bacterial Agents / therapeutic usept_PT
dc.subjectBacteremia* / microbiologypt_PT
dc.subjectChildpt_PT
dc.subjectCross Infection* / drug therapypt_PT
dc.subjectInfantpt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectMethicillin-Resistant Staphylococcus aureus*pt_PT
dc.subjectOsteomyelitis* / diagnosispt_PT
dc.subjectOsteomyelitis* / epidemiologypt_PT
dc.subjectOsteomyelitis* / therapypt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectStaphylococcal Infections* / diagnosispt_PT
dc.subjectStaphylococcal Infections* / drug therapypt_PT
dc.subjectStaphylococcal Infections* / epidemiologypt_PT
dc.subjectStaphylococcus aureuspt_PT
dc.subjectHDE INF PEDpt_PT
dc.subjectHDE ORT PEDpt_PT
dc.subjectHDE IMApt_PT
dc.titleOsteoarticular Infections in Infants Under 3 Months of Agept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue1pt_PT
oaire.citation.startPagee15212pt_PT
oaire.citation.titlePediatrics Internationalpt_PT
oaire.citation.volume64pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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