Bacterial Spectrum Analysis of Pediatric Septic Arthritis in Sanglah General Hospital (2019-2021): A Case Series
Journal of Clinical Orthopaedics | Vol 9 | Issue 1 | January-June 2024 | page: 61-69 | Ida Bagus Anom Krishna Caitanya, Made Agus Maharjana, Nyoman Gede Grenata Nanda Ustriyana
DOI: https://doi.org/10.13107/jcorth.2024.v09i01.638
Author: Ida Bagus Anom Krishna Caitanya [1], Made Agus Maharjana [1], Nyoman Gede Grenata Nanda Ustriyana [1]
[1] Department of Orthopaedics and Traumatology, Faculty of Medicine Udayana University, Prof Ngoerah General Hospital, Denpasar, Indonesia
Address of Correspondence
Dr. Ida Bagus Anom Krishna Caitanya,
Department of Orthopaedics and Traumatology, Faculty of Medicine Udayana University, Prof Ngoerah General Hospital, Denpasar, Indonesia.
E-mail: borthopaedi@gmail.com
Abstract
This case series presents five pediatric patients diagnosed with septic arthritis in Sanglah General Hospital from 2019 to 2021. The most common infecting organism was Staphylococcus aureus, comprising 66.7% of all infections. Other organisms described in literatures are Salmonella, Staphylococcus epidermidis, Enterobacter cloacae, and Mycobacterium tuberculosis. Antibiotic treatment should be started as soon as the diagnosis is suspected and modified once the organism isolated from the synovial fluid (SF) has been characterized. Unfortunately, in many cases, despite a high clinical suspicion of SA, the diagnosis cannot be confirmed because the SF is sterile on bacterial culture. This may lead to difficulties in patient management. The case series also analyzed the possible causes of negative culture results. The data showed three cases with no pathogen organism detected, which can be turned to false negative that ruled out the infection cause of the arthritis. The study suggests that in the future, other techniques might prove useful in increasing the sensitivity of the detection of bacterial infection, such as Polymerase chain reaction and detection of antibodies against the teichoic acid staphylococcal cell wall component. The detection and identification of Kingela kingae in synovial fluid have improved significantly since the development of PCR. The specificity of these assays relies on the ability of the PCR to generate only the expected amplification product. The duration of the laboratory to process is also a factor that affects the result. The study concludes that early diagnosis and prompt treatment are crucial in achieving good functional outcomes in pediatric septic arthritis.
Keywords: septic arthritis, pediatric patients, bacterial spectrum, diagnosis, culture methods
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| How to Cite this article: Caitanya IBAK, Maharjana MA, Ustriyana NGGN. Bacterial Spectrum Analysis of Pediatric Septic Arthritis in Sanglah General Hospital (2019-2021): A Case Series. Journal of Clinical Orthopaedics 2024;January-June:9(1):61-69. |
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