PDF(Pubmed)
Abstract：
BACKGROUND: Heel puncture (HP) in neonates can result in osteomyelitis if done non-aseptically or with incorrect technique. This study summarizes clinical experience with heel puncture-related osteomyelitis of the calcaneus (HP-CO) in newborns.
METHODS: We systematically reviewed studies that examined HP-CO in newborn patients using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search included the PubMed, Embase, and Cochrane Library databases until December 31, 2023. We used the National Institutes of Health (NIH) assessment scale to evaluate the quality of our analyzed studies.
RESULTS: This study analyzed 15 neonatal calcaneal osteomyelitis (CO) cases due to HP conducted in six countries from 1976 to 2016. The average age of the cases was 8.87 ± 6.13 days, with an average birth weight of 2367.27 ± 947.59 g. The infants had undergone an average of 9.00 ± 8.90 HP, with 93.33% exhibiting swelling. Staphylococcus aureus was present in 80% of cases. Beta-lactam antibiotics were used, with satisfactory outcomes in 53.33% of cases. However, in seven cases, three patients had flatfoot due to calcaneal deformity, and other complications were observed in some patients after 7-8 years.
CONCLUSIONS: This study offers valuable insights into a rare condition, including its epidemiology, clinical and laboratory characteristics, and treatment options for infants with HP-CO. To prevent the risk of osteomyelitis in this vulnerable group of patients, increasing awareness and maintaining strict aseptic techniques is necessary. We recommend that infants presenting with tenderness, redness, purulent discharge, erythema, or fever and with a history of repeated HP and swollen ankles should be evaluated for suspicion of osteomyelitis. A graphical abstract is avilable for this article.
METHODS: We systematically reviewed studies that examined HP-CO in newborn patients using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our search included the PubMed, Embase, and Cochrane Library databases until December 31, 2023. We used the National Institutes of Health (NIH) assessment scale to evaluate the quality of our analyzed studies.
RESULTS: This study analyzed 15 neonatal calcaneal osteomyelitis (CO) cases due to HP conducted in six countries from 1976 to 2016. The average age of the cases was 8.87 ± 6.13 days, with an average birth weight of 2367.27 ± 947.59 g. The infants had undergone an average of 9.00 ± 8.90 HP, with 93.33% exhibiting swelling. Staphylococcus aureus was present in 80% of cases. Beta-lactam antibiotics were used, with satisfactory outcomes in 53.33% of cases. However, in seven cases, three patients had flatfoot due to calcaneal deformity, and other complications were observed in some patients after 7-8 years.
CONCLUSIONS: This study offers valuable insights into a rare condition, including its epidemiology, clinical and laboratory characteristics, and treatment options for infants with HP-CO. To prevent the risk of osteomyelitis in this vulnerable group of patients, increasing awareness and maintaining strict aseptic techniques is necessary. We recommend that infants presenting with tenderness, redness, purulent discharge, erythema, or fever and with a history of repeated HP and swollen ankles should be evaluated for suspicion of osteomyelitis. A graphical abstract is avilable for this article.
摘要：
背景：新生儿的足跟穿刺（HP）如果非无菌或使用不正确的技术可导致骨髓炎。本研究总结了新生儿足跟穿刺相关性跟骨骨髓炎（HP-CO）的临床经验。
方法：我们使用系统评价和荟萃分析（PRISMA）指南的首选报告项目对新生儿患者HP-CO的研究进行了系统综述。我们的搜索包括PubMed,Embase,和Cochrane图书馆数据库，直到2023年12月31日。我们使用美国国立卫生研究院（NIH）评估量表来评估我们分析研究的质量。
结果：本研究分析了1976年至2016年在六个国家/地区进行的15例因HP引起的新生儿跟骨骨髓炎（CO）病例。病例平均年龄为8.87±6.13天,平均出生体重2367.27±947.59g。婴儿平均经历了9.00±8.90HP，93.33%表现出肿胀。金黄色葡萄球菌存在于80%的病例中。使用β-内酰胺抗生素，53.33%的病例结果令人满意。然而,在七个案例中，三名患者因跟骨畸形导致扁平足，一些患者在7-8年后观察到其他并发症。
结论：这项研究为一种罕见的疾病提供了有价值的见解，包括它的流行病学,临床和实验室特征，以及HP-CO婴儿的治疗选择。为了防止这群脆弱的患者发生骨髓炎的风险，提高认识和保持严格的无菌技术是必要的。我们建议出现压痛的婴儿，发红,脓性分泌物,红斑,或发热，并有反复HP和脚踝肿胀的病史，应评估是否怀疑骨髓炎。对于本文，图形摘要是可行的。
方法：我们使用系统评价和荟萃分析（PRISMA）指南的首选报告项目对新生儿患者HP-CO的研究进行了系统综述。我们的搜索包括PubMed,Embase,和Cochrane图书馆数据库，直到2023年12月31日。我们使用美国国立卫生研究院（NIH）评估量表来评估我们分析研究的质量。
结果：本研究分析了1976年至2016年在六个国家/地区进行的15例因HP引起的新生儿跟骨骨髓炎（CO）病例。病例平均年龄为8.87±6.13天,平均出生体重2367.27±947.59g。婴儿平均经历了9.00±8.90HP，93.33%表现出肿胀。金黄色葡萄球菌存在于80%的病例中。使用β-内酰胺抗生素，53.33%的病例结果令人满意。然而,在七个案例中，三名患者因跟骨畸形导致扁平足，一些患者在7-8年后观察到其他并发症。
结论：这项研究为一种罕见的疾病提供了有价值的见解，包括它的流行病学,临床和实验室特征，以及HP-CO婴儿的治疗选择。为了防止这群脆弱的患者发生骨髓炎的风险，提高认识和保持严格的无菌技术是必要的。我们建议出现压痛的婴儿，发红,脓性分泌物,红斑,或发热，并有反复HP和脚踝肿胀的病史，应评估是否怀疑骨髓炎。对于本文，图形摘要是可行的。
