An epidemiologic investigation of chronic osteomyelitis among pediatric patients admitted from 2006 to 2010 at the Philippine General Hospital
- Author:
Suzanne S. Ponio
1
;
Carmina A. Delos Reyes
1
Author Information
- Publication Type:Journal Article
- Keywords: Chronic osteomyelitis; MSSA; Pediatric osteomyelitis
- MeSH: Staphylococcus aureus; Methicillin-Resistant Staphylococcus aureus
- From: Pediatric Infectious Disease Society of the Philippines Journal 2013;14(1):14-23
- CountryPhilippines
- Language:English
-
Abstract:
Background:Osteomyelitis is a debilitating disease if not properly treated. Epidemiologic and microbiologic data will be of great importance in the direction of treatment.
Objective:To determine the epidemiologic and clinical profile of pediatric patients with chronic osteomyelitis admitted at Philippine General Hospital from 2006 to 2010.
Methodology:This is a retrospective study involving a review of medical records of pediatric patients with chronic osteomyelitis admitted at the Philippine General Hospital during the 5 year study period. Frequencies and percentages were computed for nominal data. Comparison of the different variables was done using Chisquare and Fisher Exact test.
Results: Eighty of the 134 cases of pediatric patients with chronic osteomyelitis were reviewed. Twenty-three percent of all operations involved the femur (N=18) and tibia (N=18). On radiograph, the presence of sequestrum was the most common finding noted in 53% of the cases. The predominant organism isolated in bone cultures was MSSA (40%) followed by MRSA (20%). On tissue cultures MRSA was the most common isolate in 34%, followed by MSSA(31%). Majority of the patients were given Oxacillin as empiric therapy (55%).No significant difference was observed with respect to the areas of bone involvement, signs and symptoms, radiologic findings and laboratory parameters between MSSA and MRSA osteomyelitis (p>0.05).
Conclusion:There were 239 per 100,000 cases of chronic osteomyelitis. The most common bones involved were the femur and tibia with sequestrum as the most common radiologic finding. In the previous studies, MRSA was not reported but was noted in the present study. Most of the patients in our study were treated with both antibiotics and surgery to optimize management. Ninety-eight percent of the cases had significant clinical improvement upon discharge. Based on this study, laboratory parameters, clinical manifestations and area involved cannot be utilized in differentiating MRSA from MSSA osteomyelitis. Further studies are needed to support our findings and isolation of the organism is still required for definitive identification to distinguish between MRSA from MSSA osteomyelitis. - Full text:jo44_ja02.pdf
