Etiology and Antimicrobial Susceptibility of Bacterial Septic Arthritis and Osteomyelitis

Background: to assess the distribution and resistance of the pathogens responsible for septic arthritis and osteomyelitis over a 10 years period in children admitted to children's medical center hospital, tehran, iran.methods: microbiologic and clinical presentation reports from 145 cases of septic arthritis and osteomyelitis from march 1995 to february 2005 were retrospectively reviewed.results: of 145 cases, 71(49%) had positive culture: 71.8%(51/71) of organisms were isolated from synovial fluid alone, 8.4%(6/71) from blood culture alone and 19.7% (14/71) from both synovial fluids and blood cultures. staphylococcus aureus was the most common pathogen isolated, making up 60.5% of all positive cultures, followed by klebsiella spp.(14%) and coagulase-negative staphylococci (8.4%). thirty eight percent of s. aureus and 84% of coagulase-negativestaphylococci isolates were resistant to cloxacillin. all isolates of s. aureus were susceptible to clindamycin and also, 89% were susceptible to vancomycin. among klebsiella spp., amikacin was shown to be very effective, with susceptibility rates of 100%. haemophilus influenzae was identified in only 2% of all patients.conclusion: the present study highlights the importance of haracterizing the etiology and antibiotic susceptibility of organisms causing septic arthritis or osteomylitis in children.