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Current clinical and bacteriological profile of septic arthritis in young infants: a prospective study from a tertiary referral centre

  • Original Article • PAEDIATRICS - INFECTION
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The study was carried out to evaluate the clinical and bacteriological profile of SA in young infants (age ≤ 3 months) in a tertiary referral centre and to assess the risk factors and to document the changing trends in the epidemiology.

Methods

This was a prospective descriptive study on all young infants with SA. Clinical and perinatal history, examination, radiological and laboratory findings (blood count, ESR, CRP, blood and joint cultures) were studied. Emergency arthrotomy was done and antibiotics were administered in all patients.

Result

Thirty young infants were included with a mean age of 22 ± 13.6 days and with male-to-female ratio 1.5:1. Pseudoparalysis and pain were the most common presenting symptoms. Knee joint was most commonly involved followed by hip. Ultrasound of the joint (86%) and elevated CRP levels (97%) were found to be reliable diagnostic markers. Most common causative organism was methicillin-resistant Staphylococcus aureus (43.3%) followed by Klebsiella pneumonia (23%). Sensitivity to empirical antibiotic regimen was lower (ceftriaxone 53%, amoxicillin 35%) when compared to higher antibiotics (gentamycin 88%, vancomycin 100%). Prematurity (57%), low birthweight (73%), anaemia (80%), previous history of hospitalisation (93%) and invasive procedures (90%) were found to be important risk factors.

Conclusion

The disease has distinct regional variations, and the epidemiological and bacterial profile is constantly changing. There is a shift in causative organisms towards more resistant and gram-negative species. Prematurity, low birthweight and previous hospitalisation are the major predisposing factors. A better understanding of the varied presentations is necessary for an early diagnosis and treatment, which is the most important prognostic factor.

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Authors and Affiliations

  1. Department of Orthopedics, Government Medical College, Kozhikkode, Kerala, 673008, India

    Balaji Zacharia & Antony Roy

  2. Department of Pediatrics, Government Medical College, Kozhikkode, Kerala, India

    Gireesh Sankaran & Sulaikha Puthan Purayil

Authors
  1. Gireesh Sankaran
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  2. Balaji Zacharia
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  3. Antony Roy
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  4. Sulaikha Puthan Purayil
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Corresponding author

Correspondence to Balaji Zacharia.

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The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Institute Ethics Committee, and all procedures followed were in accordance with the ethical standards

Informed consent

Individual written consent was obtained from all the individual participants included in the study.

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Sankaran, G., Zacharia, B., Roy, A. et al. Current clinical and bacteriological profile of septic arthritis in young infants: a prospective study from a tertiary referral centre. Eur J Orthop Surg Traumatol 28, 573–578 (2018). https://doi.org/10.1007/s00590-018-2142-x

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  • DOI: https://doi.org/10.1007/s00590-018-2142-x

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