{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T16:51:46Z","timestamp":1779900706882,"version":"3.53.1"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T00:00:00Z","timestamp":1493856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Paediatric acute hematogenous osteomyelitis (AHOM) is a serious disease requiring early diagnosis and treatment. To review the clinical presentation, management and organisms responsible for AHOM, and to explore risk factors for complicated AHOM, a large cohort referring to a single center over a 6-year period was evaluated. Methods: Data from children with AHOM, hospitalized between 2010 and 2015, and aged &gt; 1 month, were retrospectively collected and analyzed. Results: 121 children (median age 4.8 years; 55.4% males) were included. Fever at onset was present in 55\/121 children (45.5%); the lower limb was most frequently affected (n = 68\/121; 56.2%). Microbiological diagnosis (by culture and\/or polymerase chain reaction (PCR)) was reached in 33.3% cases. Blood and pus\/biopsy culture sensitivities were 32.4% and 46.4%, respectively. PCR sensitivity was 3.6% (2\/55) on blood, and 66.6% (16\/24) on pus\/biopsy sample. Staphylococcus aureus was the most commonly identified pathogen (n = 20); no methicillin-resistant Staphylococcus aureus (MRSA) was isolated, 10.0% (n = 2) strains were Panton-Valentine-Leukocidin (PVL) producer; 48.8% (59\/121) cases were complicated. At univariate analysis, factors associated with complicated AHOM were: recent fever episode, fever at onset, upper limb involvement, white blood count (WBC) \u2265 12,000\/\u00b5L, C reactive protein (CRP) \u2265 10 mg\/L, S. aureus infection. At multivariate analyses S. aureus infection remained the only risk factor for complicated AHOM (aOR = 3.388 (95%CI: 1.061\u201310.824); p-value = 0.039). Conclusions: In this study microbiological diagnosis was obtained in over one third of cases. Empiric treatment targeting methicillin-sensitive Staphylococcus aureus seems to be justified by available microbiological data.<\/jats:p>","DOI":"10.3390\/ijerph14050477","type":"journal-article","created":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T11:44:18Z","timestamp":1493898258000},"page":"477","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center"],"prefix":"10.3390","volume":"14","author":[{"given":"Elena","family":"Chiappini","sequence":"first","affiliation":[{"name":"Paediatric Infectious Disease Unit, Anna Meyer Children\u2019s University Hospital, Florence 50100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Camposampiero","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Disease Unit, Anna Meyer Children\u2019s University Hospital, Florence 50100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Lazzeri","sequence":"additional","affiliation":[{"name":"Orthopedics and Traumatology Department, Anna Meyer Children\u2019s University Hospital, Florence 50100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Indolfi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Anna Meyer Children\u2019s University Hospital, Florence 50100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"De Martino","sequence":"additional","affiliation":[{"name":"Meyer Health Campus, Anna Meyer Children\u2019s University Hospital, Florence 50100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-3366","authenticated-orcid":false,"given":"Luisa","family":"Galli","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Disease Unit, Anna Meyer Children\u2019s University Hospital, Florence 50100, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,5,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1111\/jpc.12251","article-title":"Systematic review of duration and choice of systemic antibiotics therapy for acute haematogenous bacterial osteomyelitis in children","volume":"49","author":"Isaacs","year":"2013","journal-title":"J. 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