1311. Associations Between Microbiological Diagnoses and Clinical Outcomes in Children with Acute Hematogenous Osteomyelitis: A Retrospective Cohort Study


 
 
 Acute hematogenous osteomyelitis (AHO) affects about 2-13 children per 100,000 in developed countries each year. Staphylococcus aureus is the most common causative pathogen of AHO and, due to antibiotic resistant strains of this species, a microbial diagnosis is often desired. Blood and bone cultures may identify causative pathogens and determine antibiotic susceptibilities but obtaining bone cultures carries risks. The benefit to patients of having a pathogen identified is disputed and further research is required to address this question. The objectives of this study were to determine if length of stay differs between culture-negative and culture-positive patients and to determine if odds of receiving 3 or more unique antibiotics differs between culture-negative and culture-positive patients.
 
 
 
 Data were retrospectively abstracted from medical records of pediatric patients with a clinician’s diagnosis of AHO admitted to Children’s National Hospital (CNH) between January 1, 2010 – June 30, 2020. Baseline characteristics, treatment, and outcomes were described. For culture-negative and culture-positive AHO patients, length of stay and odds of receiving 3 or more unique antibiotics were compared using multiple linear regression and multiple logistic regression, respectively.
 
 
 
 Of 367 included patients, 210 had a positive culture result about 83% of which were identified as S. aureus. Culture-negative patients were associated with a 6.45-day shorter length of stay compared to culture-positive patients, adjusting for age, peak C-reactive protein (CRP), and surgery (p = 0.02). Culture-negative patients had 0.196 times the odds of receiving 3 or more unique antibiotics than culture-positive patients, adjusting for age, peak CRP, and surgery (95% CI: 0.114, 0.336).
 
 
 
 Among AHO patients admitted to CNH, being culture-negative was associated with shorter length of stay and lower odds of receiving 3 or more unique antibiotics.
 
 
 
 All Authors: No reported disclosures.
