Forthcoming Issue 1 2024 Bacterial aetiology and antimicrobial susceptibility of osteo-articular infections at a tertiary-level paediatric unit in South Africa.
Main Article Content
Abstract
Background
Osteoarticular infections (OAI) are very common in children living in low-and-middle income countries, yet the bacterial aetiology and antibiotic susceptibility of OAI in children is not well described for this population. This study was designed to address this deficit in the South African context.
Methods
All patients that underwent surgery for the treatment of OAI over a 3-year period were identified and those with organisms identified from tissue, pus, fluid, or blood were included. Duplicate cultures from the same patient were excluded if the organism and antibiotic susceptibility profile was the same. Patients were categorised according to age and class of infection (Septic arthritis, acute osteomyelitis, fracture related infection, post-operative sepsis, and chronic osteomyelitis) and organisms were stratified accordingly.
Results
We identified 132 organisms from 123 samples collected from 96 patients. Most cultured organisms were from children older than 3-years with acute haematogenous septic arthritis, osteomyelitis, or both. Methicillin sensitive Staphylococcus aureus accounted for 56% (74/132) of organisms cultured. The enterobacterales accounted for 17% (22/132) of organisms cultured, mostly in the fracture related and post-operative infection groups. Of these, 6 each were extended spectrum B-lactamase producers and AmpC producers respectively. There were no carbapenemase producing Enterobacterales.
Conclusion
Methicillin sensitive Staphylococcus aureus is the most common infecting organism in paediatric OAI, and an anti-staphylococcal penicillin is the most appropriate empiric treatment for haematogenous OAI in our environment. In fracture related or post-operative infections, Enterobacterales were more frequently cultured, and treatment should be guided by culture and susceptibility results.
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