Journal article
Frequency of Multifocal Disease and Pyogenic Arthritis of the Hip in Infants with Osteoarticular Infection in Three Neonatal Intensive Care Units
The Journal of pediatrics, v 227
Dec 2020
PMID: 32707046
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To describe the clinical features of osteoarticular infection in infants cared for in neonatal intensive care units (NICUs) and to assess the presence of multifocal infection.
Retrospective medical record review with structured data abstraction of infants with osteomyelitis or pyogenic arthritis or both in NICUs at 3 children's hospitals over a 29-year period.
Of the 45 cases identified, 87% occurred in prematurely born infants, with a median gestational age of 27.4 weeks (IQR, 26, 31 weeks). Median postnatal age at diagnosis of infection was 33 days (IQR, 20, 50 days). Osteomyelitis was present without joint involvement in 53% and with joint involvement in 44% of cases. Methicillin-susceptible Staphylococcus aureus (71%) was the predominant pathogen, despite prevalent methicillin-resistant S aureus in community-associated infections. More than 1 bone was infected in 34% of cases. The femur (in 50% of patients) was the most frequently involved bone and the hip (in 20% of patients) was the most frequently involved joint. Bacteremia persisted for 4 or more days in 54% of patients with a positive blood culture despite active antimicrobial therapy.
Among infants with osteoarticular infection in NICUs, multifocal disease is common and frequently is unsuspected. Search for additional sites of infection including the hip is warranted following the diagnosis of osteoarticular infection at a single site. Involvement of contiguous joints should be suspected in cases of osteomyelitis; conversely the presence of pyogenic arthritis usually indicates extant osteomyelitis in a contiguous bone.
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Details
- Title
- Frequency of Multifocal Disease and Pyogenic Arthritis of the Hip in Infants with Osteoarticular Infection in Three Neonatal Intensive Care Units
- Creators
- Lorry G. Rubin - Donald & Barbara Zucker School of Medicine at Hofstra/NorthwellJiwoong Shin - Cohen Children's Medical CenterIshminder Kaur - St. Christopher's Hospital for ChildrenOded Scheuerman - Schneider Children’s Medical Center of Israel, Petah Tikva, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelItzhak Levy - Schneider Children’s Medical Center of Israel, Petah Tikva, Israel and Sackler School of Medicine, Tel Aviv University, Tel Aviv, IsraelSarah S. Long - St. Christopher's Hospital for Children
- Publication Details
- The Journal of pediatrics, v 227
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pediatrics
- Web of Science ID
- WOS:000591926500030
- Scopus ID
- 2-s2.0-85089980947
- Other Identifier
- 991019168744704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Pediatrics