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National epidemiological study reveals longer paediatric bone and joint infection stays for infants and in general hospitals
Author(s) -
Laurent E,
Petit L,
MaakarounVermesse Z,
Bernard L,
Odent T,
GrammaticoGuillon L
Publication year - 2018
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13909
Subject(s) - medicine , septic arthritis , osteomyelitis , incidence (geometry) , pediatrics , epidemiology , spondylodiscitis , logistic regression , disease , emergency medicine , arthritis , surgery , physics , optics
Aim Published studies have suggested that two to five days of intravenous treatment could effectively treat paediatric bone and joint infections ( PBJI ), allowing a faster discharge. This study analysed the factors associated with PBJI hospital stays lasting longer than five days using the French National Hospital Discharge Database. Methods We selected children under 15 years hospitalised in 2013 with haematogenous PBJI s using a validated French algorithm based on specific diagnosis and surgical procedure codes. Risk factors for stays of more than five days were analysed using logistic regression. Results In 2013, 2717 children were hospitalised for PBJI , with 49% staying more than five days. The overall incidence of 22 per 100 000, was highest in males and toddlers. The main causes were septic arthritis (50%) and osteomyelitis (46%) and 50% of the pathogens were Staphylococci. The odd ratios for stays of five days or more were infancy, coded bacteria and sickle cell disease (7.0), having spondylodiscitis rather than septic arthritis (2.2) and being hospitalised in a general hospital rather than a teaching hospital (1.6). Conclusion Half of the hospital stays exceeded five days, despite scientific evidence supporting a shorter intravenous antibiotherapy regimen. Greater knowledge and widespread use of short treatment regimens are needed.