Læknablaðið - 15.02.2011, Blaðsíða 32

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Bactrial osteomyelitis and arthritis in lcelandic children 1996-2005
Objective: The main objective was to determine the incidence
and causative pathogens of osteomyelitis and septic arthritis
in lcelandic children, as well as presenting symptoms and
diagnosis.
Methods: A nationwide retrospective review was done of all
children <18 year old, 1996-2005. Subjects were divided into
three equal age groups, 0-5, 6-11 and 12-17 years old. Cultures
were reviewed and postive and negative cases compared.
Results: Over the study period 220 cases were identified,
161 osteomyelitis and 59 septic arthritis cases. The incidence
increased significantly over the period (p=0.019), mostly in the
youngest age group (p<0.001) with osteomyelitis. Incidence
of cases with a pathogen identified was unchanged over the
period while culture negative cases increased significantly
(p<0.001). Median age for osteomyelitis (6,1 years) was
higher than in cases of septic arthitis (1,8 years) (p=0.003). A
pathogen was identified in 59% of cases with osteomyelitis
and 44% with septic arthritis. S. aureus was most common
(65% and 27%, respectively) and K. kingae was second most
common pathogen (7% and 11 %, respectively). Methicillin
resistant S. aureus was not identified. The tibia and knee were
the predominant sites for osteomyelitis and septic arthritis
respectively.
Conclusions: An increased incidence was found in the
youngest age group with osteomyelitis, especially in
cases without a pathogen identified. The most commonly
cultured pathogen was S. aureus, followed by K. kingae. A
more sensitive technique to identify pathogens might be
indicated in culture negative cases.
Masson AT, Gudnason Th, Jonmundsson GK, Erlendsdottir H, Kristinsson KG, Kristjansson M, Haraldsson A.
Bactrial osteomyelitis and arthritis in lcelandic children 1996-2005.
lcelMedJ 2011; 97:91-6
Key words: Osteomyelitis, septic arthritis, Staphylococcus aureus, Kingellae kingae, children.
Correspondence: Ásgeir Haraldsson, asgeir@landspitali.is
Barst: 25. mars 2010, - samþykkt til birtingar: 26. desember 2010
Hagsmunatengsl: Engin
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