{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T02:57:03Z","timestamp":1789095423833,"version":"build-2803163510"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pediatric osteoarticular infections (POAIs) are serious diseases requiring early diagnosis and treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective multicenter cohort study, children with POAIs were selected from the European Union Childhood Life-threatening Infectious Diseases Study (EUCLIDS) database to analyze their demographic, clinical, and microbiological data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A cohort of 380 patients with POAIs, 203 with osteomyelitis (OM), 158 with septic arthritis (SA), and 19 with both OM and SA, was analyzed. Thirty-five patients were admitted to the Pediatric Intensive Care Unit; out of these, six suffered from shock, one needed an amputation of the right foot and of four left toes, and two had skin transplantation. According to the Pediatric Overall Performance Score, 36 (10.5%) showed a mild overall disability, 3 (0.8%) a moderate, and 1 (0.2%) a severe overall disability at discharge. A causative organism was detected in 65% (247\/380) of patients.\n                      <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      (\n                      <jats:italic>S. aureus<\/jats:italic>\n                      ) was identified in 57.1% (141\/247) of microbiological confirmed cases, including 1 (0.7%) methicillin-resistant\n                      <jats:italic>S. aureus<\/jats:italic>\n                      (MRSA) and 6 (4.2%) Panton-Valentine leukocidin (PVL)-producing\n                      <jats:italic>S. aureus<\/jats:italic>\n                      , followed by Group A\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      (18.2%) and\n                      <jats:italic>Kingella kingae<\/jats:italic>\n                      (8.9%).\n                      <jats:italic>K. kingae<\/jats:italic>\n                      and PVL production in\n                      <jats:italic>S. aureus<\/jats:italic>\n                      were less frequently reported than expected from the literature.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      POAIs are associated with a substantial morbidity in European children, with\n                      <jats:italic>S. aureus<\/jats:italic>\n                      being the major detected pathogen. In one-third of patients, no causative organism is identified. Our observations show an urgent need for the development of a vaccine against\n                      <jats:italic>S. aureus<\/jats:italic>\n                      and for the development of new microbiologic diagnostic guidelines for POAIs in European pediatric hospitals.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2022.744182","type":"journal-article","created":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T02:52:41Z","timestamp":1651632761000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["Osteoarticular Infections in Pediatric Hospitals in Europe: A Prospective Cohort Study From the EUCLIDS Consortium"],"prefix":"10.3389","volume":"10","author":[{"given":"Andreas","family":"Trobisch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina A.","family":"Schweintzger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela S.","family":"Kohlf\u00fcrst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred G.","family":"Sagmeister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Sperl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea J.","family":"Grisold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gebhard","family":"Feierl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jethro A.","family":"Herberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enitan D.","family":"Carrol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane C.","family":"Paulus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke","family":"Emonts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"van der Flier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"de Groot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Cebey-L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Rivero-Calle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navin P.","family":"Boeddha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul-Michael","family":"Agapow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatou","family":"Secka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne T.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta","family":"Behrends","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Wintergerst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Reiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Martinon-Torres","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Levin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Werner","family":"Zenz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The EUCLIDS consortium","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1302\/0301-620X.94B5.28523","article-title":"Haematogenous acute and subacute paediatric osteomyelitis","volume":"94","author":"Dartnell","year":"2012","journal-title":"J Bone Joint Surg Br"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1302\/2058-5241.2.160027","article-title":"Paediatric bone and joint infection","volume":"2","author":"Iliadis","year":"2017","journal-title":"EFORT Open Rev."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2014.07.029","article-title":"Sequelae of pediatric osteoarticular infection","author":"Ilharreborde","year":"2015","journal-title":"Orthop Traumatol Surg Research vol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1111\/jpc.12251","article-title":"Systematic review of duration and choice of systemic antibiotic therapy for acute haematogenous bacterial osteomyelitis in children","volume":"49","author":"Howard-Jones","year":"2013","journal-title":"J Paediatr Child Health."},{"key":"B5","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1056\/NEJMra1213956","article-title":"Acute Osteomyelitis in Children","volume":"370","author":"Campion","year":"2014","journal-title":"N Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(04)01046-1","article-title":"Kingella kingae: From medical rarity to an emerging paediatric pathogen","author":"Yagupsky","year":"2004","journal-title":"Lancet Infectious Diseases vol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1186\/s12879-015-0986-9","article-title":"Kingella kingae infections in children","volume":"15","author":"Principi","year":"2015","journal-title":"BMC Infectious Diseases vol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1097\/01.inf.0000259954.88139.f4","article-title":"Specific real-time polymerase chain reaction places Kingella kingae as the most common cause of osteoarticular infections in young children","volume":"26","author":"Chometon","year":"2007","journal-title":"Pediatr Infect Dis J."},{"key":"B9","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1097\/INF.0000000000000686","article-title":"National trends in the incidence, outcomes and charges of pediatric osteoarticular infections, 1997-2012","volume":"34","author":"Stockmann","year":"2015","journal-title":"Pediatr Infect Dis J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1097\/01.bpo.0000242431.91489.b4","article-title":"Changing patterns of acute hematogenous osteomyelitis and septic arthritis: emergence of community-associated methicillin-resistant staphylococcus aureus","volume":"26","author":"Arnold","year":"2006","journal-title":"J Pediatr Orthop"},{"key":"B11","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1097\/01.inf.0000133044.79130.2a","article-title":"Community-acquired, methicillin-resistant and methicillin-susceptible staphylococcus aureus musculoskeletal infections in children.","volume":"23","author":"Martinez-Aguilar","year":"2004","journal-title":"Pediatr Infect Dis J."},{"key":"B12","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1148\/radiol.2017151929","article-title":"St Geme, J. W. Hematogenous osteomyelitis in infants and children: imaging of a changing disease","volume":"283","author":"Jaramillo","year":"2017","journal-title":"Radiology vol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"616","DOI":"10.3390\/children8080616","article-title":"Epidemiology and management of acute hematogenous osteomyelitis, neonatal osteomyelitis and spondylodiscitis in a third level paediatric center","volume":"8","author":"Musso","year":"2021","journal-title":"Children."},{"key":"B14","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1097\/INF.0000000000001309","article-title":"Epidemiology and management of acute, uncomplicated septic arthritis and osteomyelitis.","volume":"35","author":"Calvo","year":"2016","journal-title":"Pediatr Infect Dis J."},{"key":"B15","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1016\/j.cmi.2016.04.004","article-title":"Factors associated with severity in invasive community-acquired Staphylococcus aureus infections in children: a prospective European multicentre study","volume":"22","author":"Gij\u00f3n","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1042","DOI":"10.1097\/INF.0b013e318133a85e","article-title":"Pediatric bone and joint infections caused by panton-valentine leukocidin-positive Staphylococcus aureus","volume":"26","author":"Dohin","year":"2007","journal-title":"Pediatr Infect Dis J."},{"key":"B17","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1016\/S2352-4642(18)30113-5","article-title":"Life-threatening infections in children in Europe (the EUCLIDS Project): a prospective cohort study","volume":"2","author":"Martin\u00f3n-Torres","year":"2018","journal-title":"Lancet Child Adolesc Heal."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1097\/00130478-200501000-00049","article-title":"International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics","volume":"6","author":"Goldstein","year":"2005","journal-title":"Pediatr Crit Care Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1097\/INF.0000000000001635","volume":"36","author":"Saavedra-Lozano","year":"2017","journal-title":"Bone and Joint Infections. Pediatr Infect Dis J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1136\/archdischild-2011-301089","article-title":"Managing bone and joint infection in children","volume":"97","author":"Faust","year":"2012","journal-title":"Arch Dis Child"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e97259","DOI":"10.1371\/journal.pone.0097259","article-title":"Prevalence of bloodstream pathogens is higher in neonatal encephalopathy cases vs controls using a novel panel of real-time PCR assays","volume":"9","author":"Tann","year":"2014","journal-title":"PLoS ONE."},{"key":"B22","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/S0022-3476(05)82544-2","article-title":"Assessing the outcome of pediatric intensive care","volume":"121","author":"Fiser","year":"1992","journal-title":"J Pediatr"},{"key":"B23","unstructured":""},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/medicina57010036","article-title":"A comparison of the epidemiology, clinical features, and treatment of acute osteomyelitis in hospitalized children in Latvia and Norway","volume":"57","author":"Thingsaker","year":"2021","journal-title":"Medicina."},{"key":"B25","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1097\/BPO.0b013e3181ab472d","article-title":"Prospective evaluation of a shortened regimen of treatment for acute osteomyelitis septic arthritis in children","volume":"29","author":"Jagodzinski","year":"2009","journal-title":"J Pediatr Orthop."},{"key":"B26","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1177\/0009922806289081","article-title":"Success of short-course parenteral antibiotictherapy for acute osteomyelitis of childhood","volume":"46","author":"Bachur","year":"2007","journal-title":"Clin Pediatr."},{"key":"B27","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1097\/01241398-200001000-00009","article-title":"The incidence of joint involvement with adjacent osteomyelitis in pediatric patients","volume":"20","author":"Perlman","year":"2000","journal-title":"J Pediatr Orthop."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.2214\/AJR.14.12891","article-title":"Septic arthritis in children: frequency of coexisting unsuspected osteomyelitis and implications on imaging work-up and management","volume":"204","author":"Monsalve","year":"2015","journal-title":"Am J Roentgenol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1097\/BPO.0b013e318278484f","article-title":"Concurrent septic arthritis and osteomyelitis in children","volume":"33","author":"Montgomery","year":"2013","journal-title":"J Pediatr Orthop."},{"key":"B30","doi-asserted-by":"publisher","first-page":"669","DOI":"10.1097\/00006454-198611000-00014","article-title":"Pyogenic arthritis in infants and children: a review of 95 cases","volume":"5","author":"Welkon","year":"1986","journal-title":"Pediatr Infect Dis."},{"key":"B31","doi-asserted-by":"crossref","first-page":"575","DOI":"10.57187\/smw.2001.09797","article-title":"Diagnosis of acute haematogenous osteomyelitis and septic arthritis: 20 years experience at the university children's hospital basel.","volume":"131","author":"Bonhoeffer","year":"2001","journal-title":"Swiss Med Wkly"},{"key":"B32","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1111\/clm.12031","article-title":"Prospective survey of acute osteoarticular infections in a French paediatric orthopedic surgery unit","volume":"19","author":"Ferroni","year":"2013","journal-title":"Clin Microbiol Infect."},{"key":"B33","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/S1473-3099(12)70238-4","article-title":"The role of the Panton-Valentine leucocidin toxin in staphylococcal disease: a systematic review and meta-analysis","volume":"13","author":"Shallcross","year":"2013","journal-title":"Lancet Infect Dis."},{"key":"B34","doi-asserted-by":"publisher","first-page":"e73","DOI":"10.1097\/INF.0000000000002640","article-title":"Pediatric community-acquired bone and joint staphylococcus aureus infections in Europe","volume":"39","author":"Gij\u00f3n","year":"2020","journal-title":"Pediatr Infect Dis J."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1376","DOI":"10.1542\/peds.102.6.1376","article-title":"Pediatric pneumococcal bone and joint infections","volume":"102","author":"Bradley","year":"1998","journal-title":"Pediatrics."},{"key":"B36","doi-asserted-by":"publisher","first-page":"13971","DOI":"10.4414\/smw.2014.13971","article-title":"Osteoarticular infections in young children: What has changed over the last years?","volume":"144","author":"Ceroni","year":"2014","journal-title":"Swiss Med Wkly"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.1128\/JCM.00144-09","article-title":"New real-time PCR-based method for Kingella kingae DNA detection: application to samples collected from 89 children with acute arthritis","volume":"47","author":"Ilharreborde","year":"2009","journal-title":"J Clin Microbiol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1007\/s11999-009-0936-1","article-title":"Sensitivity of erythrocyte sedimentation rate and C-reactive protein in childhood bone and joint infections","volume":"468","author":"Paakkonen","year":"2010","journal-title":"Clin Orthop Relat Res."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.744182\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T05:06:11Z","timestamp":1675487171000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2022.744182\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,4]]},"references-count":38,"alternative-id":["10.3389\/fped.2022.744182"],"URL":"https:\/\/doi.org\/10.3389\/fped.2022.744182","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,4]]},"article-number":"744182"}}