儿童骨骼和关节感染的季节性，重点关注金氏金菌：系统评价。

The Seasonality of Childhood Bone and Joint Infection with Focus on Kingella kingae: A Systematic Review.

机构信息

Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

Paediatric Orthopaedic Department, Starship Hospital, Auckland, New Zealand.

出版信息

JBJS Rev. 2024 Oct 24;12(10). doi: e24.00149. eCollection 2024 Oct 1.

DOI:10.2106/JBJS.RVW.24.00149

PMID:39446985

Abstract

BACKGROUND

Seasonal trends in hospitalization for childhood bone and joint infection (BJI) are reported inconsistently. True seasonal variation would suggest an element of disease risk from environmental factors. This review evaluates all reported seasonal variations in childhood BJI, with additional analysis of seasonal trends for diseases secondary to Kingella kingae.

METHODS

A systematic review of the literature was undertaken from January 1, 1980, to August 1, 2024. Data were extracted on the hospitalization rate by season and/or month. Pathogen-specific studies for BJI secondary to K. kingae were examined separately.

RESULTS

Twenty studies met inclusion criteria encompassing 35,279 cases of childhood BJI. Most studies reported seasonal variation (n = 15, 75%). Eight studies specifically considered disease secondary to K. kingae, and all reported more frequent hospitalization in autumn and/or winter. This is in keeping with the role of respiratory pathogens and seasonal viruses in disease etiology for K. kingae BJI. Findings from other studies on the seasonality of childhood BJI were inconsistent. There were reported seasonal peaks in autumn/winter (4 studies), summer/spring (5 studies), or no variation (5 studies). Where microbiologic data were available, Staphylococcus aureus was the primary pathogen. The quality assessment demonstrated confounding and heterogeneous inclusion criteria affecting the seasonal analysis.

CONCLUSION

For childhood BJI caused by K. kingae, there appears to be a higher risk of hospitalization in autumn and/or winter months. This may relate to the seasonal circulation of respiratory viruses. There is currently insufficient evidence to support other forms of seasonal variation. Reported findings are likely affected by regional disease and pathogen characteristics.

LEVEL OF EVIDENCE

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

摘要

背景

儿童骨骼和关节感染（BJI）的住院季节性趋势报告不一致。真正的季节性变化表明存在疾病风险与环境因素有关。本综述评估了所有报道的儿童 BJI 的季节性变化，并对金氏金氏菌引起的疾病的季节性趋势进行了额外分析。

方法

对 1980 年 1 月 1 日至 2024 年 8 月 1 日的文献进行了系统综述。提取了按季节和/或月份划分的住院率数据。单独检查了金氏金氏菌引起的 BJI 的病原体特异性研究。

结果

有 20 项研究符合纳入标准，共纳入 35279 例儿童 BJI。大多数研究报告了季节性变化（n=15，75%）。8 项研究专门研究了金氏金氏菌引起的疾病，所有研究都报告说秋季和/或冬季住院人数较多。这与呼吸道病原体和季节性病毒在金氏金氏菌 BJI 发病机制中的作用相符。其他关于儿童 BJI 季节性的研究结果不一致。有研究报告秋季/冬季（4 项研究）、夏季/春季（5 项研究）或无变化（5 项研究）有季节性高峰。在有微生物学数据的情况下，金黄色葡萄球菌是主要病原体。质量评估表明，混杂因素和纳入标准的异质性影响了季节性分析。