Evolution de l'épidémiologie bactérienne dans les infections ostéo-articulaires pédiatriques à Genève

Ce travail avait pour objectif d’étudier l’épidémiologie actuelle des infections ostéo-articulaires (IOA) pédiatriques, avec une attention particulière aux différences constatées en fonction de l’âge. Pour ce faire, une étude rétrospective des dossiers d’enfants âgés de 0 à 15 ans hospitalisés à l’Hôpital des Enfants de Genève entre 2007 et 2015 pour une IOA a été réalisée (217 cas) ; les informations épidémiologiques, biologiques, bactériologiques et radiologiques ont été colligées. L’identification du germe causal a été possible dans 63.6% des cas, soit par hémocultures, soit par culture ou PCR des prélèvements opératoires. De façon inattendue, Kingella kingae constitue le principal microorganisme identifié (47.8%), devant Staphylococcus aureus (35.5%), démontrant qu’il s’agit désormais de la cause bactérienne principale d’IOA, notamment chez les enfants de moins de 4 ans. K. kingae étant un germe fastidieux et difficile à cultiver, notre étude souligne l’importance de l’utilisation de routine de la PCR pour améliorer la performance diagnostique

Pyogenic Tenosynovitis in Infants: A Case Series

Pyogenic tenosynovitis is an uncommon condition in children, and there are few published case reports. We present a series of 11 cases who were treated in the Geneva Children Hospital in the last 10 years. Kingella kingae was the main pathogen, and the characteristics of infection (inflammatory indices, clinical findings and severity) are similar to other osteoarticular K. kingae infections in infants

Pediatric Sacroiliitis: Clinical and Microbiologic Differences Between Infants and Children-Adolescents

The aim of this study was to improve knowledge of pediatric pyogenic sacroiliitis (PSI) in the pediatric population based on a consecutive case series

The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland

To assess the contemporary bacteriologic epidemiology of pediatric osteoarticular infection with particular regard to children's ages, because Kingella kingae has gained increasing recognition as the predominant pathogen for osteoarticular infection in young children

Osteoarticular infection in children

Aims: We aimed to describe the epidemiological, biological, and bacteriological characteristics of osteoarticular infections (OAIs) caused by Kingella kingae. Methods: The medical charts of all children presenting with OAIs to our institution over a 13-year period (January 2007 to December 2019) were reviewed. Among these patients, we extracted those which presented an OAI caused by K. kingae and their epidemiological data, biological results, and bacteriological aetiologies were assessed. Results: K. kingae was the main reported microorganism in our paediatric population, being responsible for 48.7% of OAIs confirmed bacteriologically.K. kingaeaffects primarily children aged between six months and 48 months. The highest prevalence of OAI caused byK. kingaewas between seven months and 24 months old. After the patients were 27 months old, its incidence decreased significantly. The incidence though of infection throughout the year showed no significant differences. Three-quarters of patients with an OAI caused byK. kingaewere afebrile at hospital admission, 11% had elevated WBCs, and 61.2% had abnormal CRPs, whereas the ESR was increased in 75%, constituting the most significant predictor of an OAI. On MRI, we noted 53% of arthritis affecting mostly the knee and 31% of osteomyelitis located primarily in the foot. Conclusion: K. kingae should be recognized currently as the primary pathogen causing OAI in children younger than 48 months old. Diagnosis of an OAI caused by K. kingae is not always obvious, since this infection may occur with a mild-to-moderate clinical and biological inflammatory response. Extensive use of nucleic acid amplification assays improved the detection of fastidious pathogens and has increased the observed incidence of OAI, especially in children aged between six months and 48 months. We propose the incorporation of polymerase chain reaction assays into modern diagnostic algorithms for OAIs to better identify the bacteriological aetiology of OAIs.</p

Kingella kingae and Osteoarticular Infections

In this study, we aimed to contrast the bacteriologic epidemiology of osteoarticular infections (OAIs) between 2 patient groups in successive 10-year periods, before and after the extensive use of nucleic acid amplification assays in the diagnostic process