Department of Orthopedics, Children's Hospital of Hebei Province, No. 133 Jianhua South Street, Shijiazhuang City, Hebei Province, China.
Scientific Research Department, Children's Hospital of Hebei Province, Shijiazhuang, Hebei, China.
Ital J Pediatr. 2024 Oct 10;50(1):212. doi: 10.1186/s13052-024-01780-0.
This study aims to identify risk factors associated with Methicillin-resistant Staphylococcus aureus (MRSA) infection in children diagnosed with acute osteomyelitis (AO) and to elucidate the laboratory characteristics of these MRSA-infected children to enhance early targeted therapeutic interventions.
We conducted a retrospective analysis involving 123 children with acute osteomyelitis treated at our hospital. Upon admission, we measured white blood cell (WBC) counts, C-reactive protein (CRP) levels, erythrocyte sedimentation rates (ESR), and platelet counts. Patients were categorized into two groups: the non-MRSA group (n = 73) and the MRSA group (n = 50), with values assigned as follows (non-MRSA group = 0, MRSA group = 1).
The MRSA group had a significantly higher average age compared to the non-MRSA group (P < 0.05). Notably, the incidence of suppurative arthritis was significantly lower in the MRSA group (P < 0.05). At the time of admission, CRP levels in the MRSA group were markedly elevated compared to those in the non-MRSA group (P < 0.01). After three days of empirical therapy, both WBC and CRP levels remained significantly higher in the MRSA group compared to the non-MRSA group (P < 0.05).
In children newly admitted with acute osteomyelitis, a CRP level exceeding 73.23 µg/mL may indicate a high likelihood of MRSA infection. For children with AO who have been hospitalized for three days on empirical therapy, the presence of WBC > 10.95 × 10^9/L, CRP > 49.56 µg/mL, age > 3.5 years, and the absence of suppurative arthritis suggests a heightened risk of MRSA infection.
本研究旨在确定与儿童急性骨髓炎（AO）诊断相关的耐甲氧西林金黄色葡萄球菌（MRSA）感染的危险因素，并阐明这些 MRSA 感染儿童的实验室特征，以加强早期靶向治疗干预。
我们对我院收治的 123 例急性骨髓炎患儿进行了回顾性分析。入院时，我们测量了白细胞（WBC）计数、C 反应蛋白（CRP）水平、红细胞沉降率（ESR）和血小板计数。患者分为两组：非耐甲氧西林金黄色葡萄球菌组（n=73）和耐甲氧西林金黄色葡萄球菌组（n=50），赋值如下（非耐甲氧西林金黄色葡萄球菌组=0，耐甲氧西林金黄色葡萄球菌组=1）。
耐甲氧西林金黄色葡萄球菌组的平均年龄明显高于非耐甲氧西林金黄色葡萄球菌组（P<0.05）。值得注意的是，耐甲氧西林金黄色葡萄球菌组化脓性关节炎的发生率明显较低（P<0.05）。入院时，耐甲氧西林金黄色葡萄球菌组的 CRP 水平明显高于非耐甲氧西林金黄色葡萄球菌组（P<0.01）。在经验性治疗三天后，耐甲氧西林金黄色葡萄球菌组的 WBC 和 CRP 水平仍明显高于非耐甲氧西林金黄色葡萄球菌组（P<0.05）。
在新入院的急性骨髓炎患儿中，CRP 水平超过 73.23µg/ml 可能提示存在耐甲氧西林金黄色葡萄球菌感染的高度可能性。对于接受经验性治疗三天住院的 AO 患儿，如果存在 WBC>10.95×10^9/L、CRP>49.56µg/ml、年龄>3.5 岁和不存在化脓性关节炎，则提示存在耐甲氧西林金黄色葡萄球菌感染的风险增加。
