Paediatric bone and joint infections are more common in boys and toddlers: a national epidemiology study

• Published in: Acta Paediatrica Vol. 102; no. 3; pp. e120 - e125
• Main Authors: Grammatico-Guillon, L, Maakaroun Vermesse, Z, Baron, S, Gettner, S, Rusch, E, Bernard, L
• Format: Journal Article
• Language: English
• Published: Norway Blackwell Publishing Ltd 01-03-2013; Wiley Subscription Services, Inc
• Subjects: Adolescent; Bone Diseases, Infectious - epidemiology; Bone Diseases, Infectious - microbiology; Bone Diseases, Infectious - therapy; Child; Child, Preschool; Cost of Illness; Databases, Factual; Epidemiology; Female; France - epidemiology; Hospital discharge database; Hospitalization - statistics & numerical data; Humans; Incidence; Infant; Joint Diseases - epidemiology; Joint Diseases - microbiology; Joint Diseases - therapy; Male; Osteomyelitis; Paediatric; Retrospective Studies; Risk Factors; Septic arthritis; France
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.12115

Aim
Little is known about bone and joint infections (BJIs) in children, despite the risk of growth disturbance. This study examined BJIs epidemiology using the French National Hospital Discharge Database (HD).
Methods
Any child <15 years hospitalized with an HD diagnosis of BJI, alone or in combination with sepsis or orthopaedic procedure, was included. The majority of BJIs (96%) were haematogenic infections. We conducted descriptive analyses to evaluate epidemiological and economic outcomes of paediatric haematogenic BJIs.
Results
There were 2592 paediatric patients with 2911 BJI hospitalizations and an overall incidence of 22 per 100 000. BJIs occurred more frequently in boys than girls (24 vs 19 per 100 000) and in toddlers. Septic arthritis (52%) and osteomyelitis (44%) were the most frequent infections, 16.6% of patients had a micro‐organism coded (61% were Staphylococci) and 13% of had comorbidities. The mean hospital stay was 8.6 days, costing approximately €5200 per BJI stay.
Conclusion
This national study of paediatric BJIs in France showed a higher prevalence in toddlers and boys and demonstrated that the HD database can be used to study BJIs. However, the number of BJI cases was maybe overestimated by coding reactive arthritis as septic arthritis in the absence of bacterial evidence.