Epidemiological Trends in Pediatric Osteoarticular Infections-Results from a Single-Center Retrospective Study Covering 2015-2023.

IF 2.1 4区医学 Q2 PEDIATRICS

Children-Basel Pub Date : 2025-09-10 DOI:10.3390/children12091210

Evelien B van Kempen, Ayla Scholma, Nam Nam Cheung, Mirjam van Veen, Joost H van Linge

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引用次数: 0

Abstract

Background: Pediatric infectious disease epidemiology has changed since the COVID-19 pandemic. To investigate possible changes in the epidemiology of pediatric osteoarticular infections (pOAIs), entailing osteomyelitis (OM), septic or infectious arthritis (AR), and osteomyelitis combined with arthritis (OA), we aimed to assess the number of pOAI cases, pathogen distribution, and outcomes across the pre-, mid-, and post-pandemic periods.

Methods: We conducted a single-center retrospective cohort study in the Dutch Juliana Children's Hospital, including patients aged 0-18 years diagnosed with OM, AR, or OA between 2015 and 2023. Cases were grouped into three periods: pre-pandemic (P1: 2015-2019), mid-pandemic (P2: 2020-2021), and post-pandemic (P3: 2022-2023). Data on demographics, clinical course, imaging, microbiology, and outcomes were extracted from medical records.

Results: A total of 118 pOAI cases (median age 2 years, IQR 1-8) were included. OM occurred in 50%, AR in 42%, and OA in 8% of cases. Annual case counts increased from an average of 10/year in P1 to 21/year in P3. Although the difference between P1 and P2 was not statistically significant (IRR 1.20; 95% CI 0.70-2.06), there was a significant increase in P3 compared to P1 (IRR 1.97; 95% CI 1.31-2.97). Pathogen detection was achieved in 50% of cases. Staphylococcus aureus remained the most frequently identified pathogen overall. From P1 to P2, proportions of Kingella kingae and GAS declined, while Staphylococcus aureus remained stable. In P3, Kingella kingae increased, Staphylococcus aureus decreased, and GAS remained relatively unchanged. However, none of these changes were statistically significant. No patients required PICU admission or experienced fatal outcomes.

Conclusion: This study suggests an increase in pOAI after the COVID-19 pandemic. While patient characteristics and outcome remained similar over time, pathogen distribution seems to have changed throughout the periods.

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儿童骨关节感染的流行病学趋势——2015-2023年单中心回顾性研究结果

背景：自2019冠状病毒病大流行以来，儿科传染病流行病学发生了变化。为了调查儿童骨关节感染（pOAIs）的流行病学可能发生的变化，包括骨髓炎（OM）、脓毒性或感染性关节炎（AR）以及骨髓炎合并关节炎（OA），我们旨在评估pOAI病例的数量、病原体分布以及大流行前、中期和后期的结果。方法：我们在荷兰朱莉安娜儿童医院进行了一项单中心回顾性队列研究，纳入了2015年至2023年间诊断为OM、AR或OA的0-18岁患者。病例分为三个时期：大流行前（P1: 2015-2019）、大流行中期（P2: 2020-2021）和大流行后（P3: 2022-2023）。从医疗记录中提取人口统计学、临床过程、影像学、微生物学和结果的数据。结果：共纳入118例pOAI病例（中位年龄2岁，IQR 1 ~ 8）。OM发生率为50%，AR发生率为42%，OA发生率为8%。年病例数从P1的平均10例/年增加到P3的21例/年。虽然P1和P2之间的差异无统计学意义（IRR 1.20; 95% CI 0.70-2.06），但P3与P1相比有显著增加（IRR 1.97; 95% CI 1.31-2.97）。50%的病例检出病原体。总的来说，金黄色葡萄球菌仍然是最常见的病原体。从P1到P2， Kingella kingae和GAS的比例下降，金黄色葡萄球菌的比例保持稳定。P3期Kingella kingae增多，金黄色葡萄球菌减少，GAS相对不变。然而，这些变化在统计学上都不显著。没有患者需要PICU或出现致命的结果。结论：本研究提示新冠肺炎大流行后pOAI增加。虽然患者的特征和结果在一段时间内保持相似，但病原体分布似乎在整个时期发生了变化。

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

Children-Basel PEDIATRICS-

CiteScore

2.70

自引率

16.70%

发文量

1735

审稿时长

6 weeks

期刊介绍： Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.