Study of Osteomyelitis in paediatric patients

Abstract

Introduction: Osteomyelitis is defined as inflammation of bone. Though the main culprits are bacteria occasionally fungi may also be involved. Prognosis of untreated or delayed treatment onset osteomyelitis is often bad and leads to adverse outcomes. Very few cases of osteomyelitis are reported from India as compared to other infectious conditions. In this study we aim to study the number of patients, male: female ratio, type of osteomyelitis and the bacterial profile associated with osteomyelitis.

Methods: After obtaining Institutional Ethics approval, the present study was conducted from 1st January 2016 - 31st December 2016 at KVG Medical College, Sullia. Blood and sample like fluid aspirate or discharge collected was subjected to microscopy and culture. Antibiotic susceptibility testing was done using disk diffusion methods. Radiological data of the patients was also collected.

Results: Bacteria were isolated from 32 cases. The most affected age group was of 6-10 years of age (46.87%). Males were more affected as compared to females and male: female ratio was 3:1. Maximum number of patients were of acute osteomyelitis (87.5%) followed by subacute osteomyelitis (9.38%) and chronic osteomyelitis was found in just a single patient (3.12%). Long bones like tibia (56.25%), femur (18.75%), humerus (12.5%) were mostly affected. Blood culture was positive in 65.62% cases. Methicillin Sensitive Staphylococcus Aureus (MSSA) was the most common isolate (56.25%) followed by, Methicillin Resistant Staphylococcus Aureus (MRSA), Acinetobacter, Coagulase Negative Staphylococcus(CONS), Streptococcus pyogens, E.coli and Pseudomonas.

Conclusion: Thus, S. aureus was the most common cause of acute bacterial osteomyelitis and mostly affected school age group children.