AUTHOR=Trobisch Andreas , Schweintzger Nina A. , Kohlfürst Daniela S. , Sagmeister Manfred G. , Sperl Matthias , Grisold Andrea J. , Feierl Gebhard , Herberg Jethro A. , Carrol Enitan D. , Paulus Stephane C. , Emonts Marieke , van der Flier Michiel , de Groot Ronald , Cebey-López Miriam , Rivero-Calle Irene , Boeddha Navin P. , Agapow Paul-Michael , Secka Fatou , Anderson Suzanne T. , Behrends Uta , Wintergerst Uwe , Reiter Karl , Martinon-Torres Federico , Levin Michael , Zenz Werner ,  The EUCLIDS consortium 

TITLE=Osteoarticular Infections in Pediatric Hospitals in Europe: A Prospective Cohort Study From the EUCLIDS Consortium

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.744182

DOI=10.3389/fped.2022.744182

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p>Pediatric osteoarticular infections (POAIs) are serious diseases requiring early diagnosis and treatment.</p></sec><sec><title>Methods</title><p>In this prospective multicenter cohort study, children with POAIs were selected from the European Union Childhood Life-threatening Infectious Diseases Study (EUCLIDS) database to analyze their demographic, clinical, and microbiological data.</p></sec><sec><title>Results</title><p>A cohort of 380 patients with POAIs, 203 with osteomyelitis (OM), 158 with septic arthritis (SA), and 19 with both OM and SA, was analyzed. Thirty-five patients were admitted to the Pediatric Intensive Care Unit; out of these, six suffered from shock, one needed an amputation of the right foot and of four left toes, and two had skin transplantation. According to the Pediatric Overall Performance Score, 36 (10.5%) showed a mild overall disability, 3 (0.8%) a moderate, and 1 (0.2%) a severe overall disability at discharge. A causative organism was detected in 65% (247/380) of patients. <italic>Staphylococcus aureus</italic> (<italic>S. aureus</italic>) was identified in 57.1% (141/247) of microbiological confirmed cases, including 1 (0.7%) methicillin-resistant <italic>S. aureus</italic> (MRSA) and 6 (4.2%) Panton-Valentine leukocidin (PVL)-producing <italic>S. aureus</italic>, followed by Group A <italic>Streptococcus</italic> (18.2%) and <italic>Kingella kingae</italic> (8.9%). <italic>K. kingae</italic> and PVL production in <italic>S. aureus</italic> were less frequently reported than expected from the literature.</p></sec><sec><title>Conclusion</title><p>POAIs are associated with a substantial morbidity in European children, with <italic>S. aureus</italic> being the major detected pathogen. In one-third of patients, no causative organism is identified. Our observations show an urgent need for the development of a vaccine against <italic>S. aureus</italic> and for the development of new microbiologic diagnostic guidelines for POAIs in European pediatric hospitals.</p></sec>