{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T13:30:19Z","timestamp":1793539819724,"version":"4.5.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,8]],"date-time":"2022-08-08T00:00:00Z","timestamp":1659916800000},"content-version":"vor","delay-in-days":219,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute osteoarticular infections (OAI) in infants under 3\u2009months of age (\u22643M) are rare and remain a diagnostic challenge. Orthopedic complications and functional sequelae have been less well described in this age group. Our aims were to evaluate trends in aetiology, management, and outcomes of OAI \u2264 3M, and to compare these younger children who have OAI with older children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A longitudinal observational study was conducted of OAI cases admitted to tertiary care pediatric hospital from 2008 to 2018. OAI \u2264 3M was compared with children above 3\u2009months. Clinical, microbiological, imaging, and outcome data were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 24 (9.1%) of the 263 OAI in children under 3\u2009months. Analyzing OAI \u2264 3M there was a twofold increase since 2014; 54% were males with a median age of 28\u2009days (IQR: 13.5\u201360.0), 10 (41.7%) were premature and nine (37.5%) had healthcare\u2010associated infections. Microbiological causes were identified in 87.5%, mostly\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (57.1%) and Group B\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      (23.8%), and 25% were multidrug\u2010resistant (5 methicillin\u2010resistant\n                      <jats:italic>S. aureus<\/jats:italic>\n                      and 1\n                      <jats:italic>Enterobacter cloacae<\/jats:italic>\n                      ). Bacteremia (100% vs 36.8%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.037), multidrug resistant bacteria (75% vs 16,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.04), and healthcare\u2010associated infections (100% vs 26.3%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.014) were associated with sequelae. Comparing OAI \u2264 3M with older children, OAI \u2264 3M were treated with longer antibiotic courses, had more complications and sequelae (17.4% vs 3.2%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      <jats:italic>S. aureus<\/jats:italic>\n                      is still the most common cause of OAI \u2264 3M, and 25% of causative bacteria were multidrug\u2010resistant bacteria. Complications and sequelae were more frequent in OAI \u2264 3M when compared with older children.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ped.15212","type":"journal-article","created":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T09:20:07Z","timestamp":1649582407000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Osteoarticular infections in infants under 3 months of age"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4501-6607","authenticated-orcid":false,"given":"Joana","family":"Branco","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Duarte","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Norte","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Arcangelo","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Alves","sequence":"additional","affiliation":[{"name":"Centro Tecnol\u00f3gico e Biom\u00e9dico, Radiodiagn\u00f3stico Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Brito","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5835-7182","authenticated-orcid":false,"given":"Delfin","family":"Tavares","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4162-8473","authenticated-orcid":false,"given":"Catarina","family":"Gouveia","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit Hospital de Dona Estef\u00e2nia, CHULC \u2013 EPE  Lisbon Portugal"},{"name":"Nova Medical School, Faculdade de Ci\u00eancias M\u00e9dicas  Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14569"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.05.012"},{"key":"e_1_2_7_4_1","first-page":"516","volume-title":"Feigin and Cherry\u2019s Textbook of Pediatric Infectious Diseases","author":"Krogstad P","year":"2019"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1413-8670(10)70085-4"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01954084"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02761144"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199512000-00004"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1179\/joc.2008.20.5.542"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001635"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2011-301089"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1442-200X.2002.01649.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-10-200211190-00007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2011.03570.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000003105"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anpedi.2020.11.031"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-1509"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medmal.2019.07.016"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001417"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001635"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2006.07.016"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e318180b3b9"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0171216"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1213956"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/pxy049"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001503"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000001309"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir034"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0b013e31817bb816"}],"container-title":["Pediatrics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.15212","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ped.15212","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ped.15212","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T13:11:42Z","timestamp":1793538702000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ped.15212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1111\/ped.15212"],"URL":"https:\/\/doi.org\/10.1111\/ped.15212","archive":["Portico"],"relation":{},"ISSN":["1328-8067","1442-200X"],"issn-type":[{"value":"1328-8067","type":"print"},{"value":"1442-200X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"2021-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15212"}}