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Aim <p>Acute hematogenous osteomyelitis (AHO) is a common problem in the pediatric age group and associated with a number of serious complications. Despite this fact, the microbiological profile of community acquired AHO (CA-AHO) has not been studied much in our region. This becomes all the more important due to the emergence of Methicillin-resistant <i>Staphylococcus</i> <i>aureus</i> (MRSA) as a major organism in osteomyelitis. This study aimed to determine the microbiological profile of CA-AHO and suggest any changes in the empiric management of AHO.</p> Patients and methods <p>120 children, fulfilling the inclusion and exclusion criteria, with CA-AHO were included in the study and the pus or altered fluid drained was sent for culture sensitivity. Antibiotic sensitivity was done using appropriate methods.</p> Results <p>Mean age of the patients was 8.47&#xa0;years, with most being from 5 to 12&#xa0;years, with fever and pain being the most common symptoms. Distal femur, proximal tibia, and distal tibia were the most common sites. Culture was positive in 103 patients (85.9%), <i>Staphylococcus</i> <i>aureus</i> being the most common organism (81.6%). MRSA was isolated in 76 patients (63.3%). All the MRSA were sensitive to Linezolid, while one patient was resistant to Vancomycin and 6 patients (7.9%) were resistant to clindamycin. Further, patients with MRSA had more severe symptoms in terms of average temperature, pulse rate, and TLC, ESR, and CRP levels on admission, with temperature and ESR being statistically significant. Patients with MRSA had higher CRP values at discharge and had a longer hospital stay, both being statistically significant.</p> Conclusion <p>MRSA is emerging as the dominant pathogen in community associated acute hematogenous osteomyelitis. This worrisome development requires a change in the treatment of this condition, especially the empiric antibiotics used. Further, a proper antibiotic policy while avoiding misuse of antibiotics may help prevent microbial resistance.</p>

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Clinico-microbiological profile and antibiotic sensitivity pattern of community acquired acute hematogenous osteomyelitis in pediatric age group: a study from a tertiary care center in North India

  • 期刊论文

  • 发表日期：

    2026年2月18日

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  • Yasir Rashid,
  • Asif Nazir Baba,
  • Nahid Nehvi,
  • Kafeel Khan,
  • Naseemul Gani

摘要

Aim

Acute hematogenous osteomyelitis (AHO) is a common problem in the pediatric age group and associated with a number of serious complications. Despite this fact, the microbiological profile of community acquired AHO (CA-AHO) has not been studied much in our region. This becomes all the more important due to the emergence of Methicillin-resistant Staphylococcus aureus (MRSA) as a major organism in osteomyelitis. This study aimed to determine the microbiological profile of CA-AHO and suggest any changes in the empiric management of AHO.

Patients and methods

120 children, fulfilling the inclusion and exclusion criteria, with CA-AHO were included in the study and the pus or altered fluid drained was sent for culture sensitivity. Antibiotic sensitivity was done using appropriate methods.

Results

Mean age of the patients was 8.47 years, with most being from 5 to 12 years, with fever and pain being the most common symptoms. Distal femur, proximal tibia, and distal tibia were the most common sites. Culture was positive in 103 patients (85.9%), Staphylococcus aureus being the most common organism (81.6%). MRSA was isolated in 76 patients (63.3%). All the MRSA were sensitive to Linezolid, while one patient was resistant to Vancomycin and 6 patients (7.9%) were resistant to clindamycin. Further, patients with MRSA had more severe symptoms in terms of average temperature, pulse rate, and TLC, ESR, and CRP levels on admission, with temperature and ESR being statistically significant. Patients with MRSA had higher CRP values at discharge and had a longer hospital stay, both being statistically significant.

Conclusion

MRSA is emerging as the dominant pathogen in community associated acute hematogenous osteomyelitis. This worrisome development requires a change in the treatment of this condition, especially the empiric antibiotics used. Further, a proper antibiotic policy while avoiding misuse of antibiotics may help prevent microbial resistance.