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Archivos de Pediatría del Uruguay

versión On-line ISSN 1688-1249

Resumen

PANDOLFO, Soledad et al. Características de las infecciones osteoarticulares por Staphylococcus aureus en niños hospitalizados: Hospital Pediátrico del Centro Hospitalario Pereira Rossell, 2009-2012.. Arch. Pediatr. Urug. [online]. 2013, vol.84, suppl.1, pp.42-47. ISSN 1688-1249.

Introduction: osteoarticular infections (OAIs) have a high morbidity. Staphylococcus aureus (SA) is the most frequent etiology. The emergence of community-associated methicillin-resistant (CA-MRSA) strains represents a problem. In 2008, the first national series on the etiology of OAIs in children is communicated. Objective: describe the clinical presentations, treatment and evolution of the OAIs for SA in children hospitalized in the Hospital Pediátrico [Pediatric Hospital] of the Centro Hospitalario Pereira Rossell [Pereira Rossell Hospital Center] (HP-CHPR) between 2009 and 2012. Materials and methods: bacteriological samples with suspect OAI were identified at the bacteriology Laboratory of the HP-CHPR. Lumbar and intra-articular punctures were included. Epidemiological characteristics, complementary tests, treatments and evolution were analyzed. Results: 283 bacteriological samples. In 92 (32,5%) the germ was identified, 53 (63%) SA. 45 were analyzed: 38 methicillin-sensitive S. aureus (MSSA), and 7 CA-MRSA. Average age: 7.7 years. 34 (75.5%) in lower limbs. 12 (27%) leukocytosis>15.000 cell/mm3, 30 (67%) CRP >20 mg/dL. Initial empiric therapy 27 children clindamycin + gentamicin. The CA-MRSA infections were more serious: multiple foci (n=1), deep venous thrombosis (n=2), septic shocks (n=2), surgical drainage (3,7/child). Longer hospital stays (average 19,5 versus 15,2 days), required longer intensive care (5,2 versus 0,13 days), and one of them passed away. Discussion: the isolation rate was similar to the one communicated in the literature. Even though the SA continues being the most frequent bacterium, in our series, the CA-MRSA has decreased, but it continues being virulent. A high grade of suspicion is necessary for an early diagnosis and opportune treatment.

Palabras clave : OSTEOARTRITIS; INFECCIONES ESTAFILOCÓCICAS; STAPHYLOCOCCUS AUREUS; NIÑO HOSPITALIZADO.

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