Abstract：
BACKGROUND: Osteoarticular infections are fairly common in children but often these are associated with underdiagnosis, delayed diagnosis and improper management. This leads to an increased incidence of complications and poor outcomes. Given the paucity of standard protocols for the management of these children in the Indian context, Indian Academy of Pediatrics (IAP) has taken the initiative to formulate guidelines for the early diagnosis and rational management of bone and joint infections (BJIs).
OBJECTIVE: To critically evaluate the current evidence and formulate consensus guidelines for the diagnosis and management of BJIs in children.
METHODS: A committee comprising of eminent national faculty from different parts of the country who are experts in the field of Pediatric Infectious Diseases, Pediatric Orthopedics and Musculoskeletal Radiology was constituted and duly approved by the IAP. On Jan 16, 2021, a virtual meeting was held and a detailed discussions were carried out regarding the need to formulate these guidelines. Subsequently, the expert group defined the key questions in the first stage followed by collection and review of scientific evidences including available national and international recommendations or guidelines. This was followed by detailed deliberation among group members and presentation of their recommendations. The same were finalized in an online meeting on Aug 01, 2021, and a consensus statement was developed and adopted by the group.
UNASSIGNED: BJIs are medical emergencies that need early diagnosis and appropriate therapy to prevent long term sequelae like limb deformities. Bacterial infections like Staphylococcus aureus is the most common etiological agent. Nonspecific and subtle clinical manifestations make the diagnosis of pediatric BJIs more challenging. Diagnosis of BJIs is primarily clinical, supplemented by laboratory and radiological investigations. The choice of antibiotic(s), mode of administration and duration of therapy requires individualization depending upon the severity of infection, causative organism, regional sensitivity patterns, time elapsed between onset of symptoms and the child\'s presentation, age, risk factors and the clinical and laboratory response to treatment. There is paucity of appropriate guidelines regarding the diagnosis and management of BJIs in children in Indian context. Hence, the need for this expert consensus guidelines in Indian settings.
OBJECTIVE: To critically evaluate the current evidence and formulate consensus guidelines for the diagnosis and management of BJIs in children.
METHODS: A committee comprising of eminent national faculty from different parts of the country who are experts in the field of Pediatric Infectious Diseases, Pediatric Orthopedics and Musculoskeletal Radiology was constituted and duly approved by the IAP. On Jan 16, 2021, a virtual meeting was held and a detailed discussions were carried out regarding the need to formulate these guidelines. Subsequently, the expert group defined the key questions in the first stage followed by collection and review of scientific evidences including available national and international recommendations or guidelines. This was followed by detailed deliberation among group members and presentation of their recommendations. The same were finalized in an online meeting on Aug 01, 2021, and a consensus statement was developed and adopted by the group.
UNASSIGNED: BJIs are medical emergencies that need early diagnosis and appropriate therapy to prevent long term sequelae like limb deformities. Bacterial infections like Staphylococcus aureus is the most common etiological agent. Nonspecific and subtle clinical manifestations make the diagnosis of pediatric BJIs more challenging. Diagnosis of BJIs is primarily clinical, supplemented by laboratory and radiological investigations. The choice of antibiotic(s), mode of administration and duration of therapy requires individualization depending upon the severity of infection, causative organism, regional sensitivity patterns, time elapsed between onset of symptoms and the child\'s presentation, age, risk factors and the clinical and laboratory response to treatment. There is paucity of appropriate guidelines regarding the diagnosis and management of BJIs in children in Indian context. Hence, the need for this expert consensus guidelines in Indian settings.
摘要：
背景：骨关节感染在儿童中相当常见，但通常与诊断不足有关，诊断延迟和管理不当。这导致并发症和不良结果的发生率增加。鉴于在印度缺乏管理这些儿童的标准协议，印度儿科学会（IAP）已主动制定骨和关节感染（BJIs）的早期诊断和合理管理指南。
目的：对目前的证据进行批判性评估，并为儿童BJIs的诊断和治疗制定共识指南。
方法：一个由来自全国各地的知名国家教师组成的委员会，他们是儿科传染病领域的专家，儿科骨科和肌肉骨骼放射学由IAP组成并正式批准。2021年1月16日，举行了一次虚拟会议，并就制定这些准则的必要性进行了详细讨论。随后，专家组在第一阶段确定了关键问题，然后收集和审查科学证据，包括现有的国家和国际建议或准则。随后，小组成员进行了详细的审议，并提出了他们的建议。在2021年8月1日的一次在线会议上最终确定了这一点，该小组制定并通过了一项共识声明。
■BJIs是医疗紧急情况，需要早期诊断和适当的治疗，以防止长期后遗症，如肢体畸形。细菌感染如金黄色葡萄球菌是最常见的病原体。非特异性和微妙的临床表现使儿童BJIs的诊断更具挑战性。BJIs的诊断主要是临床，辅以实验室和放射学调查。抗生素的选择，给药方式和治疗持续时间需要根据感染的严重程度进行个体化，致病生物，区域敏感性模式，从症状发作到孩子出现的时间，年龄,危险因素以及对治疗的临床和实验室反应。关于印度儿童BJI的诊断和管理的适当指南很少。因此，在印度环境中需要这个专家共识准则。
目的：对目前的证据进行批判性评估，并为儿童BJIs的诊断和治疗制定共识指南。
方法：一个由来自全国各地的知名国家教师组成的委员会，他们是儿科传染病领域的专家，儿科骨科和肌肉骨骼放射学由IAP组成并正式批准。2021年1月16日，举行了一次虚拟会议，并就制定这些准则的必要性进行了详细讨论。随后，专家组在第一阶段确定了关键问题，然后收集和审查科学证据，包括现有的国家和国际建议或准则。随后，小组成员进行了详细的审议，并提出了他们的建议。在2021年8月1日的一次在线会议上最终确定了这一点，该小组制定并通过了一项共识声明。
■BJIs是医疗紧急情况，需要早期诊断和适当的治疗，以防止长期后遗症，如肢体畸形。细菌感染如金黄色葡萄球菌是最常见的病原体。非特异性和微妙的临床表现使儿童BJIs的诊断更具挑战性。BJIs的诊断主要是临床，辅以实验室和放射学调查。抗生素的选择，给药方式和治疗持续时间需要根据感染的严重程度进行个体化，致病生物，区域敏感性模式，从症状发作到孩子出现的时间，年龄,危险因素以及对治疗的临床和实验室反应。关于印度儿童BJI的诊断和管理的适当指南很少。因此，在印度环境中需要这个专家共识准则。
