Acute septic arthritis as it Is seen in children At Kenyatta National Hospital

Abstract

A nine-month study was done on children with acute septic arthritis admitted to the Paediatric Orthopaedic and general paediatric wards. The aims of the study were to elucidate the clinical characteristics and aetiological agents of septic arthritis in children admitted to Kenyatta National Hospital. Thirty one children were recruited into the study and of these 58% were infants and 32.3% were school age children. There was a striking male predominance in the school age children - 9:1 while male/female ratio was 1.2:1 in the younger children. Knees and shoulders were the most frequently affected by septic arthritis and together were responsible for 71% of the septic joints. It is of interest that all the septic

shoulder joints occurred in infancy. Non-typhoidal salmonella species especially Salmonella typhimurium, Klebsiella species and Staphylococcus aureus were the most frequently isolated bacteria.

The rate of bacterial isolation was as high as 72.2% when both blood cultures and joint aspirate cultures were done. Salmonella species had 75% sensitivity to the aminoglycosides (Gentamicin,Kanamycin) and Chloramphenicol while only two thirds of the Klebsiella species were sensitive to the same antibiotics. Staphylococcus aureus isolated in this study were sensitive to Erythromycin and uniformly resistant to Ampicillin,.Cloxacillin and Cotrimoxazole. There was full

recovery in 63.7% of the patients while 23% went home without appropriate follow-up.

The author recommends that blood and joint aspirate cultures should be done in all patients suspected to have septic arthritis. Antibiotic sensitivity testing should be done r~gularly to facilitate appropriate drug therapy. Clinicians should ensure adequate follow-up of patients following discharge from hospital.