title: Update on the management of skin, soft-tissue, and osteoarticular infections in children.
abstract: OBJECTIVE
  To provide an update on the diagnosis and management of skin, soft-tissue, and osteoarticular infections in children.
  
  
  RESULTS
  Our understanding of the epidemiology of skin and soft-tissue infections and osteoarticular infections is changing rapidly. Community-associated methicillin-resistant Staphylococcus aureus has become a predominant cause of childhood skin and soft-tissue infections. Kingella kingae is also increasingly identified as a cause of osteoarticular infections. Challenges in Staphylococcus aureus treatment and Kingella kingae identification are changing the approach to skin and soft-tissue infections and osteoarticular infections.
  
  
  CONCLUSIONS
  Community-associated methicillin-resistant Staphylococcus aureus should be considered a cause of skin and soft-tissue infections. Empiric antimicrobial choices should be modified in areas in which there is a more than 10% prevalence of community-associated methicillin-resistant Staphylococcus aureus infection. Decontamination of shared sports equipment should be undertaken to minimize person-to-person spread. No established guideline for eradication of carriage of community-associated methicillin-resistant Staphylococcus aureus exists. Kingella kingae is a more prevalent cause of osteoarticular infections than previously recognized and can cause outbreaks of invasive infection via person-to-person transmission. Modification of culturing procedures for osteoarticular infections including inoculation of infected joint fluid and bone in blood-culture bottles should be considered.
authors.affiliation: Boston Medical Center, Division of Pediatric Emergency Medicine, Boston, Massachusetts 02118, USA. irene.tien@bmc.org
authors.forename: Irene
authors.initials: I
authors.lastname: Tien
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001850:Bone Diseases, Infectious / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D002648:Child; D006801:Humans; D016106:Methicillin Resistance; D016870:Neisseriaceae Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000517:prevention & control; D013207:Staphylococcal Skin Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents