Clinical characteristics and distribution and drug resistance of pathogenic bacteria in children with non-chronic osteomyelitis from a single center in Shanghai area between 2013 and 2023
10.3760/cma.j.cn311365-20241016-00290
- VernacularTitle:上海地区单中心2013年至2023年儿童非慢性骨髓炎的临床特征和病原菌分布及耐药分析
- Author:
Qiaoxin FANG
1
;
Hui YU
1
;
Yingzi YE
1
;
Lijing YE
1
;
Xia WU
1
;
Jun XU
1
;
Shuzhen HAN
1
Author Information
1. 国家儿童医学中心 复旦大学附属儿科医院感染科，上海 201102
- Publication Type:Journal Article
- Keywords:
Osteomyelitis;
Child;
Pathogenic bacteria;
Staphylococcus aureus;
Drug resistance rate
- From:
Chinese Journal of Infectious Diseases
2025;43(1):7-13
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics, distribution of common pathogenic bacteria and drug resistance in children with non-chronic osteomyelitis, to provide a basis for empirical antimicrobial drug selection.Methods:This study was a retrospective analysis cohort study. Clinical data, pathogenic bacteria and drug sensitivity test results of 289 children aged 0 to 18 years with non-chronic osteomyelitis who were hospitalized in the Pediatrics Hospital of Fudan University from January 2013 to June 2023 were collected retrospectively. Statistical analyses were performed using chi-square test.Results:Of the 289 children, 188(65.1%) were male, with a male to female ratio of 1.86∶1, and the age was 3.00(0.66, 8.00) years. The age less than six years amounted 65.1% (188/289). The incidence was the highest from December to February of the following year, reaching 32.5%(94/289). The clinical manifestations were fever in 193 cases (66.8%), fever with localized pain in 47 cases (16.3%), and fever with localized swelling and fever with localized swelling and pain in 39 cases (13.5%) each. Single bone involvement was observed in 242(83.7%) cases, including 88(36.4%) femur, 47(19.4%) tibia, and 37(15.3%) humerus. Of the 130 pathogen-positive cases, 102(78.5%) were Staphylococcus aureus (SA) including 45(44.1%) methicillin-resistant Staphylococcus aureus (MRSA), 10(7.7%) were Pseudomonas aeruginosa, and 3(2.3%) each were Klebsiella pneumoniae and Staphylococcus mansoni. The rate of MRSA detection in SA fluctuated each year from 2013 to 2023, with the highest in 2017, when eight out of 13 SA cases were MRSA. The resistance rates of all SA to vancomycin, linezolid, moxifloxacin, ciprofloxacin, gentamicin, rifampicin, ceflorin, tigecycline, ticlosporin, fosfomycin, daptomycin, furotoxin, quinupristin/dalfopristin were all zero, and the differences in resistance rates of methicillin-susceptible Staphylococcus aureus (MSSA) and MRSA to cefazolin, cefuroxime, benzoxiline, ampicillin/sulbactam, and clindamycin were all statistically significant ( χ2=68.91, 68.91, 82.00, 68.91 and 9.20, respectively, all P<0.05). Intravenous anti-infective treatment was administered for 24(35, 47) days in 289 children with osteomyelitis, for a total duration of 42.00(35.00, 47.00) days. After treatment, 287 cases (99.3%) were discharged with improvement, while two cases (0.7%) died. One death was due to phagocytosis syndrome and septic shock, and the other death was due to septic shock and multiple organ dysfunction. Conclusions:Non-chronic osteomyelitis in children is most common in male children under six years old, and the most common sites are femur, tibia and humerus. The main clinical manifestations are fever, localized swelling and pain. SA was the most common causative agent. No SA strain resistant to vancomycin, linezolid, moxifloxacin, ciprofloxacin, gentamicin, rifampicin, ceflorin, tigecycline, ticlosporin, fosfomycin, daptomycin, furotoxin, quinupristin/dalfopristin is found.
