Chronic Osteomyelitis among Children Attending Orthopedic Services at Mbarara Regional Referral Hospital: Prevalence, Etiological Agents and Their Drug Susceptibility Patterns

Abstract

Background: This cross-sectional study was conducted to determine prevalence, causative agents and their drug susceptibility patterns of chronic osteomyelitis children among 766 children attending orthopedic services at Mbarara Regional Referral Hospital between October 2016 and June 2017. Methods: Seventy-four consented patients were consecutively enrolled and their demographic characteristics, clinical and radiological data collected. Superficial and deep bone pus swabs were collected and processed as per standard operative procedures. Susceptibility testing was done using the Kirby Bauer disc diffusion technique. Data was analyzed using Stata version 13.0. Results: The prevalence of children with COM was 9.7%.  The female: Male ratio was 1:1.2 with a mean age of 11 years. The most infected bone was the tibia followed by the femur. The common clinical presentations were chronic bone pain and discharging sinus tracts whereas the most imminent radiological features were sequestrum and involcrum. Pus swabs were taken off from both the discharging sinuses and the deep intra osseous abscesses for culture and sensitivity studies. The concordance rate of the microorganisms between the superficial and the deep swabs was 62.5%. Staphylococcus aureus was the most predominant microorganism isolated (85%). All the microorganism isolates were sensitive to gentamycin. However, all Staphylococcus aureus isolated were resistant to penicillin. Conclusion: Prevalence of Chronic osteomyelitis among children with orthopedic conditions presenting to MRRH is high. The isolated microorganisms are resistant to antibiotics we commonly use in our settings.