Septic Arthritis of Neonates: Descriptive Study of a Neonatal Intensive Care Unit Nosocomial Outbreak.

Abstract

Purpose This is a retrospective descriptive study of a nosocomial outbreak of septic arthritis in a neonatal intensive care unit with a Pseudomonas species as the predominant organism. There have been no previous reports of the same. The risk factors for this disease were analysed. The different diagnostic modalities that we used are described and the short-term outcomes are reported after antibiotic therapy and surgery.Methods Fourteen patients and 16 joints were included in the study over a three-month period. The risk factors were analysed from the records and included prematurity, birth weight, sex and joint predilection. The causative organisms were also analysed from microbiological profiling. The outcomes after surgery and adjunctive antibiotic therapy were analysed in terms of clinical and laboratory parameters.Results Pseudomonas aeruginosa was found to be the predominant organism in this series. The hip joint was predominantly involved and the majority of the patients were found to be premature. All the neonates affected were found to have low birth weight.Conclusion Prematurity and low birth weight were found to have an association with risk for septic arthritis. In our setting of a nosocomial outbreak, a Pseudomonas species was more common than other organisms. A treatment regimen of arthrotomy surgery and adjunctive antibiotic therapy was found to be effective in all our patients.