title: Neonatal septic arthritis in a tertiary care hospital: a descriptive study.
abstract: OBJECTIVE
  The study was conducted to evaluate clinical and microbiological profile of neonates with septic arthritis and also to assess changing epidemiology in the microbial etiology.
  
  
  METHODS
  Twenty-nine neonates (1-28 days of life) presenting to the Department of Orthopaedics with acute septic arthritis were included in the study. This was a descriptive study, and the data were collected during the time of hospital admission. History and clinical examination of the neonates were taken, and diagnosis was made based on clinical and laboratory parameters. Emergency arthrotomy was performed to prevent catastrophic sequelae in all the cases given antibiotics as per the culture results.
  
  
  RESULTS
  Female children predominated in our study. The children were brought to the OPD with an average of 2.7 days of fever. Thirty-four joints were involved in 29 neonates, out of whom five had more than one joint involvement. Joint effusion or subperiosteal abscess was found in 22 patients by USG. All children had leukocytosis with neutrophilic predominance. Twenty-one of twenty-nine patients had hip-joint involvement followed by knee in seven patients. Gram-negative organisms had grown more commonly, among which Klebsiella pneumonia was grown in nine patients.
  
  
  CONCLUSIONS
  Prematurity and anemia still appear to be important risk factors for neonatal septic arthritis. As there is changing trend toward gram-negative infections, attention has to be given toward preventing nosocomial and community-acquired infections. This is very important in premature infants who are susceptible for infection when they are kept in resuscitative units in hospitals.
authors.affiliation: Department of Orthopedics, Kannur Medical College, PO Anjarakandy, Kannur, Kerala, 670612, India. sreenivas6@rediffmail.com.
authors.forename: T
authors.initials: T
authors.lastname: Sreenivas
authors.affiliation: Department of Orthopedics, ESI Postgraduate Medical Education and Research, Bangalore, India.
authors.forename: A R
authors.initials: AR
authors.lastname: Nataraj
authors.affiliation: Department of Orthopedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantrinagar, Pondicherry, 605006, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Orthopedics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantrinagar, Pondicherry, 605006, India.
authors.forename: Jagdish
authors.initials: J
authors.lastname: Menon
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000706:statistics & numerical data; D019637:Orthopedic Procedures / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Arthrotomy; Neonate; Prematurity; Septic arthritis