ABSTRACT
Abstract
Objective:
Studies focusing on
bone and
joint infections (BJIs) in young
infants are rare. Some cases of BJI are accompanied by
sepsis. This study aimed to identify the clinical and bacteriological features of
sepsis in
neonates and young
infants with BJIs.
Methods:
Neonates and
infants younger than 3 months diagnosed with BJI in the present institution from 2014 to 2021 were retrospectively reviewed.
Patient characteristics, clinical data, and outcomes were documented and compared between those with and without
sepsis.
Results:
Twenty-five
patients with a mean age of 34.8 days were included. Nine BJI cases had concomitant
sepsis (group A), and 16 had BJI without
sepsis (group B). Within group A,
staphylococcus aureus was the major pathogenic germ (5 cases, of which 4 were of the
methicillin-resistant staphylococcus aureus (
MRSA) type). There was no statistical difference in
male-to-
female ratio, age,
history of
hospitalization,
anemia,
birth asphyxia, peripheral
leukocyte counts,
C-reactive protein on admission, and sequelae between groups. Univariate analyses indicated a significant difference in the
incidence of
septic arthritis (SA) combined with
osteomyelitis (OM) (88.9% vs 37.5%),
congenital deformities (44.4% vs 0%), and mean duration of symptoms (2.83 days vs 9.21 days) in comparisons between groups A and B.
Conclusion:
Staphylococcus aureus is the main pathogenic
bacteria in BJI cases complicated with
sepsis in
neonates and young
infants. Among
infants younger than 3 months diagnosed with BJI, those with concurrent SA and OM,
MRSA infection, or
congenital deformities are more likely to develop
sepsis.