Osteoarticular Infections in Children: Accurately Distinguishing between MSSA and Kingella kingae
Abstract
:1. Introduction
2. Materials and Methods
2.1. Microbiological Methods
2.2. Statistical Analysis
3. Results
3.1. OAI Due to K. kingae
3.2. OAIs Due to S. aureus
3.3. Comparison of Demographic Characteristics and Clinical and Biological Features between OAIs Caused by MSSA and K. kingae
3.4. Prediction of OAIs Caused by K. kingae with Clinical and Biological Features in Children Less Than 4 Years Old
4. Discussion
5. Conclusions
6. Clinical Relevance
Author Contributions
Funding
Conflicts of Interest
References
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All Patients (n = 216) | K. kingae (n = 100) | S. aureus (n = 116) | Student t-Test | |||
---|---|---|---|---|---|---|
p | ES | 95% CI | ||||
Age, mean (SD) | 68.0 (58.9) | 19.9 (12.7) | 109.5 (51.0) | <0.001 * | 2.347 | −99.4 to −79.9 |
Temperature, mean (SD) | 37.8 (1.1) | 37.3 (0.8) | 38.2 (1.0) | <0.001 * | 1.022 | −1.2 to −0.7 |
CRP elevation, mean (SD) | 54.3 (62.7) | 24.0 (23.0) | 81.6 (73.7) | <0.001 * | 1.029 | −72.2 to −43.0 |
WBC count, mean (SD) | 11.582 (4.189) | 12.300 (3.500) | 11.000 (4.600) | 0.021 * | 0.318 | 0.2 to 2.4 |
Platelet count, mean (SD) | 360.7 (133.2) | 416.100 (115.500) | 310.900 (128.700) | <0.001 * | 0.860 | 71.7 to 138.6 |
ESR, mean (SD) | 38.8 (29.0) | 32.9 (17.5) | 44.2 (35.9) | 0.010 * | 0.391 | −19.9 to −2.7 |
GERMS | Sens./Spec./PPV/NVP (95% CI) | |||
---|---|---|---|---|
KK | MSSA | |||
Age | <43 months | 96 | 15 | Sens = 96% (90%; 99%); PPV = 86% (79%; 92%) |
≥43 months | 4 | 101 | Spec = 87% (80%; 93%); NPV = 96% (91%; 99%) | |
Temperature | <37.85 °C | 72 | 38 | Sens = 72% (62%; 81%); PPV = 65% (56%; 74%) |
≥37.85 °C | 28 | 78 | Spec = 67% (58%; 76%); NPV = 74% (64%; 82%) | |
CRP elevation | <32.5 mg/L | 79 | 34 | Sens = 79% (70%; 87%); PPV = 70% (61%; 78%) |
≥32.5 mg/L | 21 | 82 | Spec = 71% (62%; 79%); NPV = 80% (71%; 87%) | |
WBC count | <9350/mm3 | 82 | 67 | Sens = 82% (73%; 89%); PPV = 55% (47%; 63%) |
≥9350/mm3 | 18 | 49 | Spec = 42% (33%; 52%); NPV = 73% (61%; 83%) | |
Platelet count | <361,500/mm3 | 66 | 37 | Sens = 66% (56%; 75%); PPV = 64% (54%; 73%) |
≥361,500/mm3 | 34 | 79 | Spec = 68% (59%; 76%); NPV = 70% (61%; 78%) | |
ESR | <51.5 mm/h | 76 | 61 | Sens = 76% (66%; 84%); PPV = 55% (47%; 64%) |
≥51.5 mm/h | 34 | 41 | Spec = 47% (38%; 57%); NPV = 70% (58%; 79%) |
Predictors | Contrast | Univariate Logistic Regression | Multivariate Logistic Regression | ||
---|---|---|---|---|---|
OR (95% CI) | p Value | OR (95% CI) | p Value | ||
CRP | 1 mg/L increase | 0.995 (0.993–0.996) | <0.001 | 0.996 (0.994–0.998) | <0.001 |
ESR | 1 mm/h increase | 0.997 (0.993–1.000) | 0.048 | 0.998 (0.995–1.000) | 0.189 |
WBC count | 1000/mm3 increase | 0.981 (0.963–0.999) | 0.041 | 0.982 (0.964–1.000) | 0.075 |
Platelet count | 1000/mm increase | 1.000(0.999–1.000) | 0.590 | 1.000 (1.000–1.000) | 0.145 |
T. admission | 1 °C increase | 0.876 (0.812–0.946) | 0.001 | 0.962 (0.885–1.040) | 0.360 |
Intercept | - | - | - | 12.8 (0.6–279.0) | 0.109 |
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Coulin, B.; DeMarco, G.; Vazquez, O.; Spyropoulou, V.; Gavira, N.; Vendeuvre, T.; Tabard-Fougère, A.; Dayer, R.; Steiger, C.; Ceroni, D. Osteoarticular Infections in Children: Accurately Distinguishing between MSSA and Kingella kingae. Microorganisms 2023, 11, 11. https://doi.org/10.3390/microorganisms11010011
Coulin B, DeMarco G, Vazquez O, Spyropoulou V, Gavira N, Vendeuvre T, Tabard-Fougère A, Dayer R, Steiger C, Ceroni D. Osteoarticular Infections in Children: Accurately Distinguishing between MSSA and Kingella kingae. Microorganisms. 2023; 11(1):11. https://doi.org/10.3390/microorganisms11010011
Chicago/Turabian StyleCoulin, Benoit, Giacomo DeMarco, Oscar Vazquez, Vasiliki Spyropoulou, Nathaly Gavira, Tanguy Vendeuvre, Anne Tabard-Fougère, Romain Dayer, Christina Steiger, and Dimitri Ceroni. 2023. "Osteoarticular Infections in Children: Accurately Distinguishing between MSSA and Kingella kingae" Microorganisms 11, no. 1: 11. https://doi.org/10.3390/microorganisms11010011