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13. Sheftel TG, Mader ]T. Randomized evaluation of
ceftazidime or ticarcillin and tobramycin for the treatment
of osteomyelitis caused by gram-negative bacilli. Antimicrob
Agents Chemother 1986; 29:112-5.
14. Tetzlaff TR, McCracken GH, Jr., Nelson JD. Oral antibiotic
therapy for skeletal infections of children. II. Therapy of
osteomyelitis and suppurative arthritis. J Pediatr 1978; 92:
485-90.
15. Le Saux N, Howard A, Barrowman NJ, Gaboury I, Sampson
M, Moher D. Shorter courses of parenteral antibiotic therapy
do not appear to influence response rates for children with
acute hematogenous osteomyelitis: a systematic review.
BMC Infect Dis 2002; 2:16.
16. Bachur R, Pagon Z. Success of short-course parenteral
antibiotic therapy for acute osteomyelitis of childhood. Clin
Pediatr 2007; 46: 30-5.
17. Arnold SR, Elias D, Buckingham SC, et al. Changing patterns
of acute hematogenous osteomyelitis and septic arthritis:
emergence of community-associated methicillin-resistant
Staphylococcus aureus. J Pediatr Orthop 2006; 26: 703-8.
18. Ilharreborde B, Bidet P, Lorrot M, et al. New real-time
PCR-based method for Kingella kingae DNA detection:
application to samples collected from 89 children with acute
arthritis. J Clin Microbiol 2009; 47:1837-41.
19. Dodman T, Robson J, Pincus D. Kingella kingae infections in
children. J Paediatr Child Health 2000; 36: 87-90.
20. Bass S, Delmas PD, Pearce G, Hendrich E, Tabensky A,
Seeman E. The differing tempo of growth in bone size, mass,
and density in girls is region-specific. J Clin Invest 1999; 104:
795-804.
21. Blickman JG, van Die CE, Rooy JW. Current imaging
concepts in pediatric osteomyelitis. Eur Radiol 2004; 14
Suppl: L55-L64.
22. Capitanio MA, Kirkpatrick JA. Early roentgen observations
in acute osteomyelitis. Am J Roentgenol Radium Ther Nucl
Med 1970; 108: 488-96.
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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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