Article Category:
Research Article

Clinical Spectrum and Microbial Etiology of Bone and Joint Infections in Children: A Retrospective Analysis from South India

Amol Jaybhaye Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, India;

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Shyamsunder LG Department of Pediatric Orthopedics, Christian Medical College, Vellore, India;

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Nabaneeta Dash Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, India;

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Valsan Verghese Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, India;

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Anila Chacko Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, India;

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Vrisha Madhuri Department of Pediatric Orthopedics, Christian Medical College, Vellore, India;

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Thomas Palocaren Department of Pediatric Orthopedics, Christian Medical College, Vellore, India;

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Abhay Gahukamble Department of Pediatric Orthopedics, Christian Medical College, Vellore, India;

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Deeptiman James Department of Pediatric Orthopedics, Christian Medical College, Vellore, India;

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John Prakash Department of Clinical Microbiology, Christian Medical College, Vellore, India

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Winsley Rose Pediatric Infectious Diseases, Department of Pediatrics, Christian Medical College, Vellore, India;

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DOI:
https://doi.org/10.4269/ajtmh.22-0327
Volume/Issue:
Volume 108: Issue 5
Page(s):
936–941
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ABSTRACT.

Acute infections of bone and joints are medical emergencies. Early diagnosis and treatment are essential for limb salvage and prevention of deformities. Data from developing countries are essential to develop region-specific treatment guidelines including choice of empiric antibiotics. We reviewed electronic medical records of children (≤ 12 years old) admitted to the pediatrics or orthopedics department of a tertiary care hospital in South India from 2013 to 2017 with a diagnosis of septic arthritis and/or osteomyelitis. Clinical, microbiological, and follow-up data were collected and analyzed. The median (interquartile range, IQR) age of the children (N = 207) was 48 (7.5–105) months. Acute infections were more common in infants, whereas chronic cases were common in children > 5 years of age. Staphylococcus aureus (71%) was the most common organism identified. Gram-negative organisms were more frequently isolated in infants compared with older children. Blood and/or wound culture positivity was 78% (N = 161) overall and 78% (N = 31) in chronic cases. The median (IQR) duration of antibiotics was 7 (5–8) weeks. Sequelae and readmissions occurred in 47% (N = 81) of the 172 patients followed for a year. Culture positivity rates especially of wound were high even after receiving antibiotics.

Author Notes

Address correspondence to Winsley Rose, Pediatric Infectious Diseases, Department of Paediatrics, Christian Medical College, Vellore, Tamil Nadu 632004, India. E-mail: winsleyrose@cmcvellore.ac.in

Authors’ addresses: Amol Jaybhaye, Nabaneeta Dash, Valsan Verghese, Anila Chacko, and Winsley Rose, Pediatric Infectious Diseases, Department of Paediatrics, Christian Medical College, Vellore, India, E-mails: dr.amoljaybhaye@gmail.com, nabaneetadash@gmail.com, valsan@cmcvellore.ac.in, anilachacko@cmcvellore.ac.in, and winsleyrose@cmcvellore.ac.in. Shyamsunder LG, Vrisha Madhuri, Thomas Palocaren, Abhay Gahukamble, and Deeptiman James, Department of Pediatric Orthopaedics, Christian Medical College, Vellore, India, E-mails: docshyam1@gmail.com, madhuriwalter@cmcvellore.ac.in, thomaspalox@cmcvellore.ac.in, abhaygahukamble@gmail.com, and deeptiman99james@gmail.com. John Prakash, Department of Clinical Microbiology, Christian Medical College, Vellore, India, E-mail: prakjaj@cmcvellore.ac.in.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2023
Received:
16 May 2022
|
Accepted:
06 Jan 2023
|
Published Online:
10 Apr 2023
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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