{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T15:52:30Z","timestamp":1781884350310,"version":"3.54.5"},"reference-count":160,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Osteoarticular infections (OAIs) present a significant diagnostic and therapeutic challenge to paediatric clinical practice. When evaluating suspected paediatric OAIs, the principal pathogens commonly considered are Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae and Kingella kingae. However, advances in molecular diagnostic techniques, particularly polymerase chain reaction assays and next-generation sequencing, have considerably improved the detection of less commonly identified pathogens responsible for OAIs. Consequently, familiarity with fastidious, emerging, exposure-related and uncommon bacterial pathogens is essential to ensure accurate diagnoses and appropriate therapeutic interventions. This review summarises bacterial pathogens responsible for OAIs in immunocompetent children that are fastidious, emerging, exposure-related or otherwise less commonly encountered. We describe their microbiological characteristics, clinical phenotypes, diagnostic pitfalls and organism-specific diagnostic strategies.<\/jats:p>","DOI":"10.3390\/pathogens15060649","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:37:42Z","timestamp":1781879862000},"page":"649","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Osteoarticular Infections in Immunocompetent Children Due to Atypical, Fastidious or Unusual Bacterial Pathogens: A Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5894-2436","authenticated-orcid":false,"given":"Ardian","family":"Ramadani","sequence":"first","affiliation":[{"name":"Paediatric Orthopedics Unit, Geneva University Hospitals and University of Geneva, CH-1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo de","family":"Marco","sequence":"additional","affiliation":[{"name":"Paediatric Orthopedics Unit, Geneva University Hospitals and University of Geneva, CH-1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1325-8575","authenticated-orcid":false,"given":"Oscar","family":"Vazquez","sequence":"additional","affiliation":[{"name":"Paediatric Orthopedics Unit, Geneva University Hospitals and University of Geneva, CH-1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elio","family":"Paris","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Geneva, CH-1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6530-3471","authenticated-orcid":false,"given":"Andreas","family":"Tsoupras","sequence":"additional","affiliation":[{"name":"Paediatric Orthopedics Unit, Geneva University Hospitals and University of Geneva, CH-1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Steiger","sequence":"additional","affiliation":[{"name":"Paediatric Orthopedics Unit, Geneva University Hospitals and University of Geneva, CH-1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5439-4226","authenticated-orcid":false,"given":"Romain","family":"Dayer","sequence":"additional","affiliation":[{"name":"Paediatric Orthopedics Unit, Geneva University Hospitals and University of Geneva, CH-1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4038-4881","authenticated-orcid":false,"given":"Dimitri","family":"Ceroni","sequence":"additional","affiliation":[{"name":"Paediatric Orthopedics Unit, Geneva University Hospitals and University of Geneva, CH-1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"649","DOI":"10.2106\/JBJS.21.01040","article-title":"Predictive Algorithms in the Diagnosis and Management of Pediatric Hip and Periarticular Infection","volume":"104","author":"Hunter","year":"2022","journal-title":"J. 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