title: The epidemiology of pediatric bone and joint infections in Cambodia, 2007-11.
abstract: There are limited data on osteoarticular infections from resource-limited settings in Asia. A retrospective study of patients presenting to the Angkor Hospital for Children, Cambodia, January 2007-July 2011, identified 81 cases (28% monoarticular septic arthritis, 51% single-limb osteomyelitis and 15% multisite infections). The incidence was 13.8/100 000 hospital attendances. The median age was 7.3 years, with a male/female ratio of 1.9:1; 35% presented within 5 days of symptom onset (median 7 days). Staphylococcus aureus was cultured in 29 (36%) cases (52% of culture-positive cases); one isolate was methicillin-resistant (MRSA). Median duration of antimicrobial treatment was 29 days (interquartile range 21-43); rates of surgical intervention were 96%, and 46% of children had sequelae, with one fatality. In this setting osteoarticular infections are relatively common with high rates of surgical intervention and sequelae. Staphylococcus aureus is the commonest culturable cause, but methicillin-resistant S. aureus is not a major problem, unlike in other Asian centers.
authors.affiliation: Angkor Hospital for Children, Siem Reap, Cambodia. nicole.stoesser@ndm.ox.ac.uk
authors.forename: Nicole
authors.initials: N
authors.lastname: Stoesser
authors.forename: Joanna
authors.initials: J
authors.lastname: Pocock
authors.forename: Catrin E
authors.initials: CE
authors.lastname: Moore
authors.forename: Sona
authors.initials: S
authors.lastname: Soeng
authors.forename: PutChhat
authors.initials: P
authors.lastname: Hor
authors.forename: Poda
authors.initials: P
authors.lastname: Sar
authors.forename: Direk
authors.initials: D
authors.lastname: Limmathurotsakul
authors.forename: Nicholas
authors.initials: N
authors.lastname: Day
authors.forename: Varun
authors.initials: V
authors.lastname: Kumar
authors.forename: Sophy
authors.initials: S
authors.lastname: Khan
authors.forename: Vuthy
authors.initials: V
authors.lastname: Sar
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Parry
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010019:Osteomyelitis / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D010372:Pediatrics; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents