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

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.

KEYWORDS:

• Acute haematogenous osteomyelitis
• children
• risk factors
• Staphylococcus aureus
• subacute haematogenous osteomyelitis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

E Chiappini, A Krzysztofiak, and L Galli coordinated the data collection, C Lisi performed data entry and statistical analyses, E Chiappini drafted the manuscript, all other authors participated and in data collection, interpretation of results and read and approved the final draft.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

The manuscript was not funded.