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 journalArticlepeer-review


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
Issue number4
Publication statusPublished - Apr 2018


  • 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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