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Vol. 14. Issue 4.
Pages 413-418 (July - August 2010)
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Vol. 14. Issue 4.
Pages 413-418 (July - August 2010)
Brief communication
Open Access
Osteoarthritis in the neonate: risk factors and outcome
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2745
Griselda Berberian1,
Corresponding author
griselberberian@yahoo.com.ar

Correspondence to: Pico 2265, 1429 Buenos Aires, Argentina. Tel.: +54-11-47031188.
, Verónica Firpo1, Adriana Soto1, Julio Lopez Mañan1, Cecilia Torroija1, Graciela Castro1, Pablo Polanuer2, Camilo Espinola2, José Luis Piñeiro3, María Teresa Rosanova1
1 Department of Infectious Diseases, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
2 Orthopaedic Surgery, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
3 Microbiology, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
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Abstract
Objectives

The aim of this study was to identify the clinical, radiological, and bacteriological features, risk factors, and outcome of neonates with bone and joint infections.

Study design

Observational, retrospective, and analytical study of 77 patients less than 2 months of age, admitted to a tertiary neonatal intensive care unit (NICU) with the diagnosis of bone or joint infection, based on clinical, radiological, and microbiological criteria.

Results

Seventy-seven patients with 99 acute osteoarthritis foci in a 16 year period were included in the study. Risk factors for infection could be identified in 69% of the patients. The hip was the most frequent. Staphylococcus aureus was the main isolated microorganism. Twenty-nine infants (38%) had sequelae. Hip involvement, culture positive, and Staphylococcus aureus isolation were risk factors associated with sequelae.

Conclusion

Osteoarticular infection is unusual in the neonate; however it is associated with an elevated incidence of sequelae. This mandates for a high degree of suspicion to diagnose this potentially disabling entity.

Keywords:
osteoarthritis
neonate
Staphylococcus aureus
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References
[1.]
D. Goldmann, W. Durbin, J. Freeman.
Nosocomial infections in a neonatal intensive care unit.
J Infect Dis, 144 (1981), pp. 449-459
[2.]
S. Bergdahl, Ekengren k, M. Erriksson.
Neonatal hematogenous osteomyelitis: risk factors for long-term sequelae.
J Pediatr Orthop, 5 (1985), pp. 564-582
[3.]
Williamson, C. Galasko, M. Robinson.
Outcome after acute osteomyelitis in preterm infants.
Arch Dis Child, 65 (1990), pp. 1060-1062
[4.]
L. Hunka, S. Said, D. Mac Kenzie, et al.
Classification and surgical management of the severe sequelae of septic hips in children.
Clin Orthop, 171 (1982), pp. 30-36
[5.]
G. Coto-Cotallo, G. Solis-Sanchez, M. Crespo-Hernandez, et al.
osteomielitis neonatal: estudio de una serie de 35 casos.
Ann Esp pediatr, 33 (1990), pp. 429
[6.]
B. Frederiksen, P. Christiansen, F. Knudsen, et al.
Acute oseomyelitis and septic arthritis in the neonate, risk factors and outcome.
Eur J Pediatr, 152 (1993), pp. 577-580
[7.]
B. Asmar.
Osteomyelitis in the neonate.
Inf Dis Clin of North Am, 6 (1992), pp. 117-132
[8.]
L. Fox, K. Sprunt.
Neonatal osteomyelitis.
Pediatrics, 62 (1978), pp. 535-542
[9.]
J. Ogden.
Pediatric osteomyelitis and septic arthritis. The patology of neonatal oseomyelitis.
Yale J Biol Med, 52 (1979), pp. 423-448
[10.]
M. Wong, D. Isaacs, R. Howman- Giles, R. Uren.
Clinical and diagnostic features of osteomyelitis occurring in the first three months of life.
Pediatr Infect Dis J, 14 (1995), pp. 1047
[11.]
J. Sarlangue, C. Castella, J. Pontailler, J. Chateil.
Neonatal infections of the bone and joints.
Archives de Pédiatrie, (2007), pp. S108-S112
[12.]
M. Dan.
Septic arthritis in young infants: clinical and microbiologic correlations and therapeutic implications.
Rev Inf Dis, 6 (1984), pp. 147-155
[13.]
G. Overturf, M. Marcy.
Bacterial Infections of the Bones and Joints.
Infectious Diseases of the Fetus and Newborn Infant, pp. 1019-1103
[14.]
M. Al Saadi, F.A. Al Zamil, N.A. Bokary, et al.
Acute septic arthritis in children.
Pediatrics International, 51 (2009), pp. 377-380
[15.]
Prober C.Clinical approach to the infected neonate. In: Long S, Pickering L- Prober C editors. Principles and practice of pediatric infectious disease. II edition 2006. Chapter 97; 533- 42.
[16.]
M. Weinstein, C. Stratton, H. Hawley, et al.
Multicenter collaborative evaluation of standardize serum bactericidal test as a predictor of therapeutic efficacy in acute and chronic osteomyelitis.
Am J Med, 83 (1987), pp. 218-223
[17.]
L. Unkila-Kallio, M. Kallio, H. Peltola.
The usefulness of C-reactive protein levels in the identification of concurrent septic arthritis in children who have acute hematogenous osteomyelitis.
J Bone and Joint Surg, 6 (1994), pp. 848-853
[18.]
I. Roine, A. Arguedas, Faingezicht, et al.
Early detection of sequela- prone osteomyelitis in children with use of simple clinical and laboratory criteria.
Clin Infect Dis, 2 (1997), pp. 489-553
[19.]
A. Dessi, M. Crisafulli, Accossu, et al.
Osteo-articular infections in newborns: diagnosis and treatment.
J Chemother, 20 (2008), pp. 542-550
[20.]
E. Korakaki, A. Aligizakis, A. Manoura, et al.
Methicillin-resistant Staphylococus aureus osteomielitis and septic arthritis in neonates: diagnosis and treatment.
JPN J Infect Dis, 60 (2007), pp. 129-131
[21.]
H. Peltola, M. Paakkonen, Kallio, et al.
Prospective, randomized trial of 10 days versus 30 days of antimicrobial treatment, including a short term course of parenteral therapy, for childhood septic arthritis.
CID, 48 (2009), pp. 1201-1210
[22.]
N.A. Jagodzinski, R. Kanwar, K. Graham, C.E. Bache.
Prospective evaluation of a shortened regimen of treatment for acute osteomyelitis and septic arthritis in children.
J Pediatr Orthop, 9 (2009), pp. 518-525
[23.]
D. Ceroni, M. Regusci, J.M. Pazos, et al.
Risk and complications of prolonged parenteral antibiotic treatment in children with acute osteoarticular infections.
Act Orthop Belg, 69 (2003), pp. 400-404
[24.]
J.D. Nelson.
The bacterial etiology an antibiotic management of septic arthritis in infants and children.
Pediatrics, 50 (1972), pp. 437-440
[25.]
H. Kim, B. Alman, W. Cole.
A Shortened course of parenteral antibiotic therapy in de management of acute septic arthritis of the hip.
Journal of Pediatric Orthopaedics, 20 (2000), pp. 44-47
[26.]
R. Dagan, R.F. Jacobs.
Management of acute hematogenous osteomyelitis and septic arthritis in pediatric patient.
Pediatr Infect Dis J, 14 (1995), pp. 40-44
[27.]
C. Wang, S. Wang, Y. Yang, et al.
Septic arthritis in children: relationship of causative pathogens, complications, and outcome.
J Microbiol Immunol Infect, 36 (2003), pp. 41-46
[28.]
A. Narang, K. Mukhopadhyay, P. Kumar, et al.
Bone and joint infection in neonate.
Indian J Pediatr, 65 (1998), pp. 461-464
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