Frontiers in Pediatrics (May 2022)
Osteoarticular Infections in Pediatric Hospitals in Europe: A Prospective Cohort Study From the EUCLIDS Consortium
- Andreas Trobisch,
- Andreas Trobisch,
- Andreas Trobisch,
- Nina A. Schweintzger,
- Daniela S. Kohlfürst,
- Manfred G. Sagmeister,
- Matthias Sperl,
- Andrea J. Grisold,
- Gebhard Feierl,
- Jethro A. Herberg,
- Enitan D. Carrol,
- Stephane C. Paulus,
- Marieke Emonts,
- Marieke Emonts,
- Marieke Emonts,
- Michiel van der Flier,
- Michiel van der Flier,
- Ronald de Groot,
- Miriam Cebey-López,
- Miriam Cebey-López,
- Irene Rivero-Calle,
- Irene Rivero-Calle,
- Navin P. Boeddha,
- Paul-Michael Agapow,
- Fatou Secka,
- Suzanne T. Anderson,
- Uta Behrends,
- Uwe Wintergerst,
- Karl Reiter,
- Federico Martinon-Torres,
- Federico Martinon-Torres,
- Michael Levin,
- Werner Zenz,
- The EUCLIDS consortium
Affiliations
- Andreas Trobisch
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
- Andreas Trobisch
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
- Andreas Trobisch
- Research Group for Neonatal Infectious Diseases, Medical University of Graz, Graz, Austria
- Nina A. Schweintzger
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
- Daniela S. Kohlfürst
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
- Manfred G. Sagmeister
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
- Matthias Sperl
- Department of Orthopedics and Traumatology, Pediatric Orthopedic Unit, Medical University of Graz, Graz, Austria
- Andrea J. Grisold
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- Gebhard Feierl
- Diagnostic and Research Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
- Jethro A. Herberg
- Section of Pediatric Infectious Disease, Imperial College London, London, United Kingdom
- Enitan D. Carrol
- Department of Clinical Infection Microbiology and Immunology, University of Liverpool Institute of Infection, Veterinary and Ecological Sciences, Liverpool, United Kingdom
- Stephane C. Paulus
- Department of Clinical Infection Microbiology and Immunology, University of Liverpool Institute of Infection, Veterinary and Ecological Sciences, Liverpool, United Kingdom
- Marieke Emonts
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- Marieke Emonts
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Centre Based at Newcastle upon Tyne Hospitals NHS Trust and Newcastle University, Newcastle upon Tyne, United Kingdom
- Marieke Emonts
- 0Pediatric Infectious Diseases and Immunology Department, Newcastle upon Tyne Hospitals Foundation Trust, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
- Michiel van der Flier
- 1Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology and Laboratory of Infectious Diseases, Radboud Institute of Molecular Life Sciences, Nijmegen, Netherlands
- Michiel van der Flier
- 2Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital University Medical Center Utrecht, Utrecht, Netherlands
- Ronald de Groot
- 1Department of Pediatrics, Division of Pediatric Infectious Diseases and Immunology and Laboratory of Infectious Diseases, Radboud Institute of Molecular Life Sciences, Nijmegen, Netherlands
- Miriam Cebey-López
- 3Translational Pediatrics and Infectious Diseases Section- Pediatrics Department, Santiago de Compostela, Spain
- Miriam Cebey-López
- 4Instituto de Investigación Sanitaria de Santiago (IDIS), Genetics- Vaccines- Infectious Diseases and Pediatrics Research Group (GENVIP), Santiago de Compostela, Spain
- Irene Rivero-Calle
- 3Translational Pediatrics and Infectious Diseases Section- Pediatrics Department, Santiago de Compostela, Spain
- Irene Rivero-Calle
- 4Instituto de Investigación Sanitaria de Santiago (IDIS), Genetics- Vaccines- Infectious Diseases and Pediatrics Research Group (GENVIP), Santiago de Compostela, Spain
- Navin P. Boeddha
- 5Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
- Paul-Michael Agapow
- Section of Pediatric Infectious Disease, Imperial College London, London, United Kingdom
- Fatou Secka
- 6Medical Research Council Unit the Gambia, Banjul, Gambia
- Suzanne T. Anderson
- 6Medical Research Council Unit the Gambia, Banjul, Gambia
- Uta Behrends
- 7Department of Pediatrics and of Pediatric Surgery, Technische Universität München, Munich, Germany
- Uwe Wintergerst
- 8Department of Pediatrics, Hospital St. Josef, Braunau, Austria
- Karl Reiter
- 9Department of Pediatric Intensive Care, University Children's Hospital at Dr. von Haunersche Kinderklinik, Ludwig-Maximilians-Universität München, Munich, Germany
- Federico Martinon-Torres
- 3Translational Pediatrics and Infectious Diseases Section- Pediatrics Department, Santiago de Compostela, Spain
- Federico Martinon-Torres
- 4Instituto de Investigación Sanitaria de Santiago (IDIS), Genetics- Vaccines- Infectious Diseases and Pediatrics Research Group (GENVIP), Santiago de Compostela, Spain
- Michael Levin
- Section of Pediatric Infectious Disease, Imperial College London, London, United Kingdom
- Werner Zenz
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
- The EUCLIDS consortium
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
- DOI
- https://doi.org/10.3389/fped.2022.744182
- Journal volume & issue
-
Vol. 10
Abstract
BackgroundPediatric osteoarticular infections (POAIs) are serious diseases requiring early diagnosis and treatment.MethodsIn this prospective multicenter cohort study, children with POAIs were selected from the European Union Childhood Life-threatening Infectious Diseases Study (EUCLIDS) database to analyze their demographic, clinical, and microbiological data.ResultsA cohort of 380 patients with POAIs, 203 with osteomyelitis (OM), 158 with septic arthritis (SA), and 19 with both OM and SA, was analyzed. Thirty-five patients were admitted to the Pediatric Intensive Care Unit; out of these, six suffered from shock, one needed an amputation of the right foot and of four left toes, and two had skin transplantation. According to the Pediatric Overall Performance Score, 36 (10.5%) showed a mild overall disability, 3 (0.8%) a moderate, and 1 (0.2%) a severe overall disability at discharge. A causative organism was detected in 65% (247/380) of patients. Staphylococcus aureus (S. aureus) was identified in 57.1% (141/247) of microbiological confirmed cases, including 1 (0.7%) methicillin-resistant S. aureus (MRSA) and 6 (4.2%) Panton-Valentine leukocidin (PVL)-producing S. aureus, followed by Group A Streptococcus (18.2%) and Kingella kingae (8.9%). K. kingae and PVL production in S. aureus were less frequently reported than expected from the literature.ConclusionPOAIs are associated with a substantial morbidity in European children, with S. aureus being the major detected pathogen. In one-third of patients, no causative organism is identified. Our observations show an urgent need for the development of a vaccine against S. aureus and for the development of new microbiologic diagnostic guidelines for POAIs in European pediatric hospitals.
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