Reduction in osteomyelitis and septic arthritis related to Haemophilus influenzae type B vaccination.
This retrospective cohort study compares organisms responsible for septic arthritis and osteomyelitis before and after Haemophilus influenzae type b vaccination. Before vaccination, Haemophilus influenzae type b was responsible for 5% of culture positive osteomyelitis and 41% of culture positive septic arthritis. Since the administration of the conjugated vaccine PRP-T began in 1992, no case of osteomyelitis or septic arthritis has been caused by Haemophilus influenzae type b (p < 0.005, t test). Vaccination has succeeded in eliminating Haemophilus influenzae type b as an infective agent in hematogenous septic arthritis and osteomyelitis. Current empirical antibiotic therapy for hematogenous septic arthritis and osteomyelitis need only cover gram-positive agents in vaccinated infants and children of all age groups.
Howard
A W
AW
Division of Orthopaedics, Children's Hospital of Eastern Ontario, and University of Ottawa, Canada. andrew.howard@ibm.net
Viskontas
D
D
Sabbagh
C
C
D000293:Adolescent; D017677:Age Distribution; D001170:Arthritis, Infectious / Q000453:epidemiology / Q000517:prevention & control*; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006192:Haemophilus Infections / Q000517:prevention & control*; D018073:Haemophilus Vaccines / Q000008:administration & dosage*; D019741:Haemophilus influenzae type b / Q000276:immunology*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010019:Osteomyelitis / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D017678:Sex Distribution
D018073:Haemophilus Vaccines