Résumé
Orthopedic device-related infection (ODRI) is a major postoperative complication. Our aim was to describe the clinical, biological and bacteriological characteristics, management and evolution of ODRIs in children. Methods: we conducted a retrospective, observational study at Montpellier University Hospital from January 2015 to June 2023. All children under 16 years of age, with a diagnosis of ODRI, defined as the presence of clinical signs requiring surgical revision, were included. Data were collected from computerized medical records. Results: 69 cases of ODRIs were included. Initial surgical indications were: 25 fractures, 16 non-idiopathic scoliosis (NIS), 12 idiopathic scoliosis (IS) and 16 other orthopedic anomalies. Infections were polymicrobial in 33% of cases. Staphylococcus aureus (SA) was isolated in 42 cases/69, gram-negative bacilli (GNB) in 16 cases/69 and anaerobic germs in 9 cases/69 (none on fracture). SA was involved in 76% of ODRI on fracture-related infections. 63% of non-idiopathic scoliosis were affected by BGN and 58% by anaerobic germs. Empirical antibiotic treatment was mainly conducted with the association Piperacillin/tazobactam and vancomycin (n=38). Mean duration of intravenous antibiotic therapy was 18 days. Median duration of total antibiotic therapy was 7 weeks with implant removal and 14 weeks with implant retention. Conclusion: staphylococcus aureus is the first cause of ODRIs in pediatric patients. In second place, gram-negative bacteria predominate in case of NIS and anaerobic bacteria in case of IS. Surgical indication and comorbidities have to be considered for antibiotic prophylaxis and empirical treatment.