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

  • Gireesh Sankaran
  • Balaji ZachariaEmail author
  • Antony Roy
  • Sulaikha Puthan Purayil



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.


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.


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.


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.


Neonate Osteomyelitis Low birthweight Joint Knee MRSA 


Compliance with ethical standards

Conflict of interest

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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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OrthopedicsGovernment Medical CollegeKozhikkodeIndia
  2. 2.Department of PediatricsGovernment Medical CollegeKozhikkodeIndia

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