Microbiological Spectrum and Antibiotic Susceptibility in Septic Arthritis: Insights from a Tertiary Pediatric Centre in Karnataka
J Bhavana, Abhishek S Bhasme, Kiran Rajappa, Mahantesh Sangappa, Rudraprasad M S, Sreeharsha Gangappa
Author(s)2 Assistant professor, Department of Paediatric orthopaedics, Indira Gandhi Institute of Child Health, Bengaluru, India
3Associate professor, Department of Paediatric orthopaedics, Indira Gandhi Institute of Child Health, Bengaluru, India
4Professor & HOD, Department of Microbiology, Indira Gandhi Institute of Child Health, Bengaluru, India
5Professor& HOD, Department of Paediatric orthopaedics, Indira Gandhi Institute of Child Health, Bengaluru, India
6MLT Microbiology & Immunology, Department of Microbiology, Indira Gandhi Institute of Child Health, Bengaluru, India
Abstract
Background: Neonatal septic arthritis (SA) is an infection and inflammation of the synovial membrane with purulent effusion caused by bacterial or fungal pathogens. It is a serious deep-seated infection in neonates, with a global incidence of 0.3 per 1000 live births and 0.6 per 1000 live births in India. Early diagnosis is challenging due to subtle clinical signs. Material and Methods: This observational study was conducted at a tertiary pediatric referral centre in Karnataka. A total of 55 pus, synovial fluid, and tissue samples from neonates with suspected SA were collected between July 2023 and June 2024. Samples were Gram-stained and inoculated onto Blood Agar, MacConkey Agar, Sabouraud Dextrose Agar, and Thioglycolate broth, incubated aerobically at 37°C for 24–48 hours. Positive cultures were identified by colony characteristics, Gram staining, biochemical reactions, and Vitek2 confirmation. Fungal growth was also noted. All bacterial isolates underwent antimicrobial susceptibility testing as per CLSI guidelines. Results: Of 55 samples, 33 (60%) were culture positive. The most common isolate was Klebsiella pneumoniae, followed by Staphylococcus aureus. Klebsiella pneumoniae showed highest susceptibility to Meropenem and Imipenem (28.57%) and Cotrimoxazole (21.43%). Staphylococcus aureus was 100% susceptible to Linezolid, Cotrimoxazole, and Vancomycin. Conclusion: Klebsiella pneumoniae and Staphylococcus aureus are the predominant pathogens causing neonatal SA in this setting. Early identification and culture-directed antibiotic therapy are essential to prevent joint damage and improve outcomes.
Keywords: Septic arthritis, Neonatal SA, Microbiological profile, Antibiogram.