Risk factors associated with complications/sequelae of acute and subacute haematogenous osteomyelitis: an Italian multicenter study

Elena Chiappini, Andrzej Krzysztofiak, Elena Bozzola, Clara Gabiano, Susanna Esposito, Andrea Lo Vecchio, Maria Rita Govoni, Cristina Vallongo, Icilio Dodi, Elio Castagnola, Nadia Rossi, Piero Valentini, Fabio Cardinale, Filippo Salvini, Gianni Bona, Grazia Bossi, Alma Nunzia Olivieri, Fiorella Russo, Emilio Fossali, Gabriella BottoneMarta Dellepiane, Maurizio De Martino, Alberto Villani, Luisa Galli

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae.

METHODS: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged >1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed.

RESULTS: 300 children with AHOM and 98 with SAHOM were included. Median age was 6.0 years (IQR: 2.0-11.0). No clinical difference was observed with the exception of fever at onset (63.0% vs. 42.9%; P < 0.0001), and a more common spinal involvement in SAHOM (6.7% vs 20.4%; P < 0.001). Fifty-Eight Staphylococcus aureus strains were isolated; 5 (8.6%) were MRSA. No Kingella kingae infection was documented. No different risk for complication/sequela was observed between AHOM and SAHOM (38.3% vs. 34.7%; OR:0.85; 95%CI: 0.53-1.38; P = 0.518). Duration and type of antibiotic therapy were not associated with risk of complication/sequelae.

CONCLUSION: AHOM and SAHOM displayed some differences, however occurrence and risk factors for complications and sequelae are similar, and the same empiric treatment might be recommended.

Original languageEnglish
Pages (from-to)351-358
Number of pages8
JournalExpert Review of Anti-Infective Therapy
Volume16
Issue number4
DOIs
Publication statusPublished - Apr 2018

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Osteomyelitis
Multicenter Studies
Kingella kingae
Methicillin-Resistant Staphylococcus aureus
Italy
Staphylococcus aureus
Epidemiology
Fever
Pediatrics
Anti-Bacterial Agents
Therapeutics
Infection

Keywords

  • Acute Disease
  • Adolescent
  • Anti-Bacterial Agents/administration & dosage
  • Child
  • Child, Preschool
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Italy/epidemiology
  • Male
  • Methicillin-Resistant Staphylococcus aureus/isolation & purification
  • Osteomyelitis/complications
  • Retrospective Studies
  • Risk Factors
  • Staphylococcal Infections/epidemiology

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Risk factors associated with complications/sequelae of acute and subacute haematogenous osteomyelitis : an Italian multicenter study. / Chiappini, Elena; Krzysztofiak, Andrzej; Bozzola, Elena; Gabiano, Clara; Esposito, Susanna; Lo Vecchio, Andrea; Govoni, Maria Rita; Vallongo, Cristina; Dodi, Icilio; Castagnola, Elio; Rossi, Nadia; Valentini, Piero; Cardinale, Fabio; Salvini, Filippo; Bona, Gianni; Bossi, Grazia; Olivieri, Alma Nunzia; Russo, Fiorella; Fossali, Emilio; Bottone, Gabriella; Dellepiane, Marta; De Martino, Maurizio; Villani, Alberto; Galli, Luisa.

In: Expert Review of Anti-Infective Therapy, Vol. 16, No. 4, 04.2018, p. 351-358.

Research output: Contribution to journalArticle

Chiappini, E, Krzysztofiak, A, Bozzola, E, Gabiano, C, Esposito, S, Lo Vecchio, A, Govoni, MR, Vallongo, C, Dodi, I, Castagnola, E, Rossi, N, Valentini, P, Cardinale, F, Salvini, F, Bona, G, Bossi, G, Olivieri, AN, Russo, F, Fossali, E, Bottone, G, Dellepiane, M, De Martino, M, Villani, A & Galli, L 2018, 'Risk factors associated with complications/sequelae of acute and subacute haematogenous osteomyelitis: an Italian multicenter study', Expert Review of Anti-Infective Therapy, vol. 16, no. 4, pp. 351-358. https://doi.org/10.1080/14787210.2018.1453357
Chiappini, Elena ; Krzysztofiak, Andrzej ; Bozzola, Elena ; Gabiano, Clara ; Esposito, Susanna ; Lo Vecchio, Andrea ; Govoni, Maria Rita ; Vallongo, Cristina ; Dodi, Icilio ; Castagnola, Elio ; Rossi, Nadia ; Valentini, Piero ; Cardinale, Fabio ; Salvini, Filippo ; Bona, Gianni ; Bossi, Grazia ; Olivieri, Alma Nunzia ; Russo, Fiorella ; Fossali, Emilio ; Bottone, Gabriella ; Dellepiane, Marta ; De Martino, Maurizio ; Villani, Alberto ; Galli, Luisa. / Risk factors associated with complications/sequelae of acute and subacute haematogenous osteomyelitis : an Italian multicenter study. In: Expert Review of Anti-Infective Therapy. 2018 ; Vol. 16, No. 4. pp. 351-358.
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T1 - Risk factors associated with complications/sequelae of acute and subacute haematogenous osteomyelitis

T2 - an Italian multicenter study

AU - Chiappini, Elena

AU - Krzysztofiak, Andrzej

AU - Bozzola, Elena

AU - Gabiano, Clara

AU - Esposito, Susanna

AU - Lo Vecchio, Andrea

AU - Govoni, Maria Rita

AU - Vallongo, Cristina

AU - Dodi, Icilio

AU - Castagnola, Elio

AU - Rossi, Nadia

AU - Valentini, Piero

AU - Cardinale, Fabio

AU - Salvini, Filippo

AU - Bona, Gianni

AU - Bossi, Grazia

AU - Olivieri, Alma Nunzia

AU - Russo, Fiorella

AU - Fossali, Emilio

AU - Bottone, Gabriella

AU - Dellepiane, Marta

AU - De Martino, Maurizio

AU - Villani, Alberto

AU - Galli, Luisa

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae.METHODS: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged >1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed.RESULTS: 300 children with AHOM and 98 with SAHOM were included. Median age was 6.0 years (IQR: 2.0-11.0). No clinical difference was observed with the exception of fever at onset (63.0% vs. 42.9%; P < 0.0001), and a more common spinal involvement in SAHOM (6.7% vs 20.4%; P < 0.001). Fifty-Eight Staphylococcus aureus strains were isolated; 5 (8.6%) were MRSA. No Kingella kingae infection was documented. No different risk for complication/sequela was observed between AHOM and SAHOM (38.3% vs. 34.7%; OR:0.85; 95%CI: 0.53-1.38; P = 0.518). Duration and type of antibiotic therapy were not associated with risk of complication/sequelae.CONCLUSION: AHOM and SAHOM displayed some differences, however occurrence and risk factors for complications and sequelae are similar, and the same empiric treatment might be recommended.

AB - BACKGROUND: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae.METHODS: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged >1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed.RESULTS: 300 children with AHOM and 98 with SAHOM were included. Median age was 6.0 years (IQR: 2.0-11.0). No clinical difference was observed with the exception of fever at onset (63.0% vs. 42.9%; P < 0.0001), and a more common spinal involvement in SAHOM (6.7% vs 20.4%; P < 0.001). Fifty-Eight Staphylococcus aureus strains were isolated; 5 (8.6%) were MRSA. No Kingella kingae infection was documented. No different risk for complication/sequela was observed between AHOM and SAHOM (38.3% vs. 34.7%; OR:0.85; 95%CI: 0.53-1.38; P = 0.518). Duration and type of antibiotic therapy were not associated with risk of complication/sequelae.CONCLUSION: AHOM and SAHOM displayed some differences, however occurrence and risk factors for complications and sequelae are similar, and the same empiric treatment might be recommended.

KW - Acute Disease

KW - Adolescent

KW - Anti-Bacterial Agents/administration & dosage

KW - Child

KW - Child, Preschool

KW - Female

KW - Hospitalization

KW - Humans

KW - Infant

KW - Italy/epidemiology

KW - Male

KW - Methicillin-Resistant Staphylococcus aureus/isolation & purification

KW - Osteomyelitis/complications

KW - Retrospective Studies

KW - Risk Factors

KW - Staphylococcal Infections/epidemiology

U2 - 10.1080/14787210.2018.1453357

DO - 10.1080/14787210.2018.1453357

M3 - Article

C2 - 29569505

VL - 16

SP - 351

EP - 358

JO - Expert Review of Anti-Infective Therapy

JF - Expert Review of Anti-Infective Therapy

SN - 1478-7210

IS - 4

ER -