Etiology and Antimicrobial Susceptibility of Bace rial Septic Arthritis and Osteomyelitis

Abstract: To assess the distribution and resistance of the pathogens responsible for septic arthritis and osteomyelitis over a 10 years period in children admitted to Children''s Medical Center Hospital, Tehran, Iran. Microbiologic and clinical presentation reports from 145 cases of septic arthritis and osteomyelitis from March 1995 to February 2005 were retrospectively reviewed. Of 145 cases, 71(49%) had positive culture: 71.8%(51/71) of organisms were isolated from synovial fluid alone, 8.4%(6/71) from blood culture alone and 19.7% (14/71) from both synovial fluids and blood cultures. Staphylococcus aureus was the most common pathogen isolated, making up 60.5% of all positive cultures, followed by Klebsiella spp. (14%) and coagulase-negative staphylococci (8.4%). Thirty eight percent of S. aureus and 84% of coagulase-negative staphylo­cocci isolates were resistant to cloxacillin. All isolates of S. aureus were susceptible to clindamycin and also, 89% were susceptible to vancomycin. Among Klebsiella spp., amikacin was shown to be very effective, with susceptibility rates of 100%. Haemophilus influenzae was identified in only 2% of all patients. The present study highlights the importance of characterizing the etiology and antibiotic susceptibility of organ­isms causing septic arthritis or osteomylitis in children.