Wong Maria, Williams Nicole, Cooper Celia
Department of Orthopaedic Surgery, Women and Children's Hospital, Adelaide, SA, Australia.
Center for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, SA, Australia.
Pediatric Health Med Ther. 2020 Feb 24;11:73-84. doi: 10.2147/PHMT.S217475. eCollection 2020.
, a pathogen often responsible for musculoskeletal infections in children is the most common cause of septic arthritis and osteomyelitis in children 6 to 36 months of age. The aim of this study was to perform a systematic review of previous studies to determine the proportion of in bacteriologically proven musculoskeletal infections among the pediatric population. A secondary objective was to describe the diagnostic strategies and outcome of patients with musculoskeletal infections caused by . A systematic review was conducted to identify publications that report on musculoskeletal infections caused by in the pediatric population (patients 0 to <18 years old with microbiologic culture and/or polymerase chain reaction (PCR) confirmation of and a description of the musculoskeletal infection involved). Of 144 studies included in this review, we sought to determine the proportion of pediatric musculoskeletal infections. A total of 711 (30.8%) out of 2308 pediatric cases with culture and/or PCR proven musculoskeletal infections had successfully identified from twenty-nine studies. Of the 1070 patients who were aged less than 48 months, was the organism identified in 47.6% of infections. We found the average age from the collated studies to be 17.73 months. Of 520 pediatric musculoskeletal patients in which infections were identified and where the studies reported the sites of infection, a large proportion of cases (65%) were joint infections. This was followed by 18.4% osteoarticular infection (concomitant bone and joint involvement), with isolated bone and spine at 11.9% and 3.5%, respectively. Twenty-one papers reported clinical and laboratory findings in children with confirmed infection. The median temperature reported at admission was 37.9°C and mean was 38.2°C. Fourteen studies reported on impact and treatment, with the majority of children experiencing good clinical outcome and function following antibiotic treatment with no serious orthopaedic sequelae.
一种通常导致儿童肌肉骨骼感染的病原体是6至36个月大儿童化脓性关节炎和骨髓炎的最常见病因。本研究的目的是对先前的研究进行系统综述，以确定该病原体在经细菌学证实的儿童肌肉骨骼感染中的比例。次要目标是描述由该病原体引起的肌肉骨骼感染患者的诊断策略和结局。进行了一项系统综述，以识别报告儿童人群（0至<18岁，微生物培养和/或聚合酶链反应（PCR）证实该病原体且描述了所涉及的肌肉骨骼感染）中由该病原体引起的肌肉骨骼感染的出版物。在本综述纳入的144项研究中，我们试图确定该病原体所致儿童肌肉骨骼感染的比例。在2308例经培养和/或PCR证实有肌肉骨骼感染的儿科病例中，共有711例（30.8%）通过29项研究成功鉴定出该病原体。在1070名年龄小于48个月的患者中，该病原体在47.6%的感染中被鉴定出来。我们从汇总研究中发现平均年龄为17.73个月。在520例鉴定出该病原体感染且研究报告了感染部位的儿科肌肉骨骼患者中，很大一部分病例（65%）为关节感染。其次是18.4%的骨关节炎感染（骨和关节同时受累），孤立性骨感染和脊柱感染分别占11.9%和3.5%。21篇论文报告了确诊该病原体感染儿童的临床和实验室检查结果。入院时报告的中位体温为37.9°C，平均体温为38.2°C。14项研究报告了影响和治疗情况，大多数儿童在接受抗生素治疗后临床结局良好且功能正常，无严重骨科后遗症。
