{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:49:19Z","timestamp":1787755759071,"version":"build-2784847793"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","funder":[{"name":"Health and Research Council New Zealand","award":["HRC24\/100"],"award-info":[{"award-number":["HRC24\/100"]}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Seasonal trends in hospitalization for childhood bone and joint infection (BJI) are reported inconsistently. True seasonal variation would suggest an element of disease risk from environmental factors. This review evaluates all reported seasonal variations in childhood BJI, with additional analysis of seasonal trends for diseases secondary to\n                      <jats:italic toggle=\"yes\">Kingella kingae<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A systematic review of the literature was undertaken from January 1, 1980, to August 1, 2024. Data were extracted on the hospitalization rate by season and\/or month. Pathogen-specific studies for BJI secondary to\n                      <jats:italic toggle=\"yes\">K. kingae<\/jats:italic>\n                      were examined separately.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty studies met inclusion criteria encompassing 35,279 cases of childhood BJI. Most studies reported seasonal variation (n = 15, 75%). Eight studies specifically considered disease secondary to\n                      <jats:italic toggle=\"yes\">K. kingae<\/jats:italic>\n                      , and all reported more frequent hospitalization in autumn and\/or winter. This is in keeping with the role of respiratory pathogens and seasonal viruses in disease etiology for\n                      <jats:italic toggle=\"yes\">K. kingae<\/jats:italic>\n                      BJI. Findings from other studies on the seasonality of childhood BJI were inconsistent. There were reported seasonal peaks in autumn\/winter (4 studies), summer\/spring (5 studies), or no variation (5 studies). Where microbiologic data were available,\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      was the primary pathogen. The quality assessment demonstrated confounding and heterogeneous inclusion criteria affecting the seasonal analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      For childhood BJI caused by\n                      <jats:italic toggle=\"yes\">K. kingae<\/jats:italic>\n                      , there appears to be a higher risk of hospitalization in autumn and\/or winter months. This may relate to the seasonal circulation of respiratory viruses. There is currently insufficient evidence to support other forms of seasonal variation. Reported findings are likely affected by regional disease and pathogen characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      <jats:underline>Prognostic Level III<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.24.00149","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T14:00:49Z","timestamp":1729778449000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["The Seasonality of Childhood Bone and Joint Infection with Focus on Kingella kingae"],"prefix":"10.2106","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6436-3244","authenticated-orcid":false,"given":"Sarah","family":"Hunter","sequence":"first","affiliation":[{"name":"Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand"},{"name":"Paediatric Orthopaedic Department, Starship Hospital, Auckland, New 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