%0 Journal Article
%T Microorganisms and Their Sensitivity Pattern in Septic Arthritis of North Indian Children: A Prospective Study from Tertiary Care Level Hospital
%A Sanjay Yadav
%A Mandeep Singh Dhillon
%A Sameer Aggrawal
%A Sujit Kumar Tripathy
%J ISRN Orthopedics
%D 2013
%R 10.1155/2013/583013
%X Background. Septic arthritis is a true orthopaedic emergency. Important factors determining outcome are rapid diagnosis and timely intervention. Changing trends in microbiological spectrum and emerging drug resistance poses big challenge. Present study evaluates bacterial strains and their sensitivity pattern in septic arthritis of North Indian children. Methods. Fifty children with septic arthritis of any joint were evaluated. Joint was aspirated and 2£¿cc of aspirated fluid was sent for gram stain and culture. Blood cultures were also sent for bacteriological evaluation. Results. Fifty percent cases had definite radiological evidence of septic arthritis whereas ultrasound revealed fluid in 98% cases. Aspirated fluid showed isolates in 72% cases. The most common organism was Staphylococcus aureus (62%) followed by Streptococcus pneumoniae and Gr. B Streptococcus. Blood culture could grow the organism in 34% cases only. The bacterial strain showed significant resistance to common antibiotic cocktail in routine practice. Resistance to cloxacillin and ceftriaxone was 62% and 14% respectively. No organisms were resistant to vancomycin and linezolid. Conclusion. S. aureus is still the most common organism in septic arthritis. Though a significant resistance to common antibiotic cocktail is noticed, the strain is susceptible to higher antibiotics. We recommend using these antibiotics as an empirical therapy till culture and sensitivity report is available. 1. Introduction Septic arthritis is a true orthopaedic emergency. Delay in its diagnosis and treatment can lead to disastrous complications like destruction of articular cartilage, physeal damage, and dislocation of joints (Figure 1) [1¨C3]. Despite significant improvement in medicine with availability of better antibiotics, septic arthritis is still a major cause of morbidity. The cause is multifactorial as there is a shift in the microbiological spectra and epidemiology with emerging antibiotic resistance. This also has a distinct geographical variation [4¨C8]. Figure 1: Septic arthritis causing pathological dislocation. Native joint septic arthritis is usually secondary to hematogenous seeding of joint during transient or persistent bacteraemia [1, 2, 9]. Early treatment is essential before damage to the articular cartilage occurs. This mandates empirical antibiotic therapy without awaiting culture report [1, 2, 4]. Because of wide variation in microbiological spectrum and their sensitivity, a constant antibiotic regimen cannot be designed for all children. Accordingly, this prospective study was conducted
%U http://www.hindawi.com/journals/isrn.orthopedics/2013/583013/