Bone and Joint Infections in Children With Sickle Cell Disease in French Guiana: A 13-Year Retrospective Multicenter Review.

IF 2.9 4区 医学 Q3 IMMUNOLOGY
Pediatric Infectious Disease Journal Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI:10.1097/INF.0000000000004416
Apolline Furgier, Juliette Goutines, Succes Dobian, Magaly Zappa, Magalie Demar, Nadjia Aigoun, Bruno Oubda, Albert Faye, Narcisse Elenga, Lindsay Osei
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Abstract

Introduction: Sickle cell disease (SCD) is a genetic disorder with a high infectious morbidity and mortality and a heterogeneous distribution in France. One of the challenges is to differentiate a bone and joint infection (BJI) from a vaso-occlusive crisis. This challenge is particularly prevalent in French Guiana, an overseas territory with the highest incidence of SCD in France. The aim of this study was to describe the epidemiology of BJI in children with SCD in French Guiana.

Method: This was a retrospective multicentric descriptive study of SCD patients living in French Guiana aged under 18 and diagnosed with a BJI between 2010 and 2022. These BJI were divided into 2 groups: those with microbiological documentation (d-BJI) and those without microbiological identification (ud-BJI).

Results: A total of 53 episodes of BJI in 42 patients (mean age 7.2 years) were reported. Clinical symptoms on arrival were comparable between the d-BJI and ud-BJI groups. Patients in the d-BJI group had longer average hospital stays (40.4 days vs. 16.8 days, P = 0.01) and Salmonella spp. were the most identified bacteria (n = 8/13). White blood cell count was greater in the d-BJI group (30.3 G/L vs. 18.G/L, P = 0.01) and a collection was more frequently identified on imaging (11/13 vs. 16/40, P = 0.01) in this group. Initial in-hospital antibiotic therapy was longer in the d-BJI group (17.2 days vs. 12.8, P = 0.02), as were infection-related complications (9/13 vs. 12/40 P = 0.01).

Conclusion: BJI in children with SCD is not sufficiently microbiologically documented. Progress must be made to improve the documentation of BJI.

法属圭亚那镰状细胞病患儿的骨与关节感染:13年回顾性多中心研究。
导言:镰状细胞病(SCD)是一种遗传性疾病,感染性发病率和死亡率都很高,在法国的分布也不尽相同。其中一项挑战是如何区分骨关节感染(BJI)和血管闭塞性危象。这一难题在法属圭亚那尤为普遍,该海外领地是法国 SCD 发病率最高的地区。本研究旨在描述法属圭亚那 SCD 患儿骨关节感染的流行病学:这是一项回顾性多中心描述性研究,研究对象为 2010 年至 2022 年期间居住在法属圭亚那、年龄在 18 岁以下、被诊断为 BJI 的 SCD 患者。这些 BJI 被分为两组:有微生物学记录(d-BJI)和无微生物学鉴定(ud-BJI):结果:共报告了 42 名患者(平均年龄 7.2 岁)的 53 次 BJI。d-BJI组和ud-BJI组患者抵达时的临床症状相当。d-BJI 组患者的平均住院时间较长(40.4 天 vs. 16.8 天,P = 0.01),沙门氏菌是最常见的细菌(n = 8/13)。d-BJI 组的白细胞计数更高(30.3 G/L vs. 18.G/L, P = 0.01),该组患者在造影中更常发现集合体(11/13 vs. 16/40,P = 0.01)。d-BJI组最初的院内抗生素治疗时间更长(17.2天 vs. 12.8天,P = 0.02),感染相关并发症也更长(9/13 vs. 12/40 P = 0.01):结论:SCD患儿的BJI没有得到充分的微生物学记录。结论:SCD患儿的BJI在微生物学方面的记录不够充分,必须在改进BJI的记录方面取得进展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.30
自引率
2.80%
发文量
566
审稿时长
2-4 weeks
期刊介绍: ​​The Pediatric Infectious Disease Journal® (PIDJ) is a complete, up-to-the-minute resource on infectious diseases in children. Through a mix of original studies, informative review articles, and unique case reports, PIDJ delivers the latest insights on combating disease in children — from state-of-the-art diagnostic techniques to the most effective drug therapies and other treatment protocols. It is a resource that can improve patient care and stimulate your personal research.
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