Department of Orthopaedic Surgery, University of Auckland, Waikato Hospital, Pembroke Street, Hamilton West, 3204, New Zealand.
Department of Orthopaedic Surgery, Hawke's Bay Hospital, University of Auckland, Auckland, New Zealand.
Infection. 2022 Apr;50(2):329-341. doi: 10.1007/s15010-021-01741-3. Epub 2022 Jan 20.
Childhood bone and joint infection (BJI) is a potentially severe disease that may have permanent sequelae, including growth impairment and limb deformity. It has been characterised in the literature with a focus on Western epidemiology; there are currently no reports detailing global epidemiology and bacteriology. This omits key data from determining temporal trends, appropriate antibiotic therapy, and resource allocation. This review aims to identify studies that characterise the incidence of childhood bone and joint infection or provide detailed bacteriology within their region.
A systematic review of the literature was performed from 01/01/1980 to 31/12/2020. Data has been analysed to give incidence of disease per 100,000 children, primary pathogen by country where available, and risk ratio (RR) for disease by ethnicity. This is applicable for areas that experience race-related inequitable burden of disease.
Forty-four articles met the inclusion area; of these, seven were population-wide studies, primarily from Europe or the United States, and the remainder were cohort studies. Incidence could be derived from 26 studies compromising over 34, 000 children. Information on bacteriology was available from 39 publications (10, 957 cases). Methicillin-sensitive Staphylococcus aureus is the most common pathogen in the West. Recently, disease secondary to Kingella kingae and methicillin-resistant S. aureus has increased. Salmonella remains a dominant pathogen in African regions. Increased risk of disease is observed in Aboriginal, New Zealand Māori, Pacific, Indigenous Fijian, and Bedouin children.
The current state of the literature detailing incidence of childhood BJI focuses on disease patterns from the West. There is a paucity of high-quality publications in the developing world. Despite these limitations, global trends in burden of disease show race-related inequitable risk of BJI. Temporal and regional variation in bacteriology can be demonstrated.
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儿童骨骼关节感染（BJI）是一种潜在的严重疾病，可能会产生永久性后遗症，包括生长受损和肢体畸形。该疾病在文献中已有描述，重点是西方的流行病学；目前尚无详细描述全球流行病学和细菌学的报告。这使得确定时间趋势、适当的抗生素治疗和资源分配的关键数据缺失。本综述旨在确定描述儿童骨骼关节感染发病率或提供其所在地区详细细菌学特征的研究。
对 1980 年 1 月 1 日至 2020 年 12 月 31 日的文献进行系统综述。分析数据以给出每 10 万名儿童的疾病发病率、按国家提供的主要病原体以及按种族划分的疾病风险比（RR）。这适用于那些经历与种族相关的疾病负担不平等的地区。
有 44 篇文章符合纳入标准；其中，7 篇为全人群研究，主要来自欧洲或美国，其余为队列研究。26 项研究中有 26 项研究可以得出发病率，涉及超过 34000 名儿童。39 篇出版物（10，957 例）提供了有关细菌学的信息。耐甲氧西林金黄色葡萄球菌是西方最常见的病原体。最近，金氏金氏菌和耐甲氧西林金黄色葡萄球菌引起的疾病有所增加。沙门氏菌仍然是非洲地区的主要病原体。在澳大利亚原住民、新西兰毛利人、太平洋地区、斐济土著人和贝都因人儿童中，疾病的风险增加。
目前详细描述儿童 BJI 发病率的文献侧重于西方的疾病模式。在发展中国家，高质量出版物的数量较少。尽管存在这些局限性，但全球疾病负担的趋势表明 BJI 存在与种族相关的风险不平等。可以证明细菌学的时间和区域变化。
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