The Hip: Preservation, Replacement and Revision

Bacteriology of Orthopaedic Infections in Neonates



- See:
      - Osteomyelitis in New Born
      - Septic Hip

- Bacteriology:
    - in hospital-acquired cases, staphylococci are the predominant isolates (about 60%), followed by Group B streptococcus, candida & gram-negative bacilli;
          - these infections often stem from invasive procedures such as catheterization of the umbilical vessels, central lines, and intra-osseous lines;
    - in community-acquired septic arthritis, Group B. streptococci are the most frequent (52 %), followed by staphylococci (26 %) & gonococci (17%);
          - this usually means oxacillin 200 mg/kg/day and gentamycin 7.5 mg/kg/day;
    - in infants and children 1 month to 3 years old, the predominant organism causing hematogenous septic arthritis historically was haemophilus
          influenzae, followed by staphylococci and streptococci;
          - predominance of H. influenza has significantly declined since a vaccine has been developed;
          - in the study by Peltola H, et al. (1998), the incidence of haemophilus influenza septic arhtritis was 0% after 10 years of routine vaccination;
                - Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment.

- Treatment Agents:
    - oxacillin
    - cephalosporin type III (rocephin)


References

Septic Arthritis in Infants Younger Than 3 Months: A Retrospective Review

Septic arthritis in young infants: clinical and microbiologic correlations and therapeutic implications.

Long-term follow-up of infantile hip sepsis.

Sequelae and reconstruction after septic arthritis of the hip in infants.

Etiology and medical management of acute suppurative bone and joint infections in pediatric patients.

Antibiotic concentrations in septic joint effusions.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Saturday, November 14, 2015 11:32 am