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Updated: Jul 13, 2025
A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
Published on: August 12, 2020
Bone and joint infection complicated with sepsis in neonates and infants under three months of age
1Children's Hospital of Soochow University, Department of Orthopaedics, Suzhou, Jiangsu Province, China.
Insights
Staphylococcus aureus, particularly MRSA, is a common cause of sepsis in young infants with bone and joint infections (BJIs). Infants with combined septic arthritis and osteomyelitis or congenital deformities face higher sepsis risk.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Sepsis Research
- Musculoskeletal Infections in Infants
Background:
- Bone and joint infections (BJIs) are uncommon in neonates and young infants.
- BJIs can be associated with severe systemic illness, including sepsis.
- Limited data exists on the specific features of sepsis in this vulnerable population.
Purpose of the Study:
- To identify clinical and bacteriological characteristics of sepsis in neonates and young infants diagnosed with BJIs.
- To compare features and outcomes between BJI patients with and without sepsis.
Main Methods:
- Retrospective review of neonates and infants (<3 months) with BJIs from 2014-2021.
- Documentation of patient demographics, clinical data, and outcomes.
- Comparison of characteristics between BJI patients with and without sepsis.
Main Results:
- Twenty-five patients were analyzed; 9 had sepsis (Group A) and 16 did not (Group B).
- Staphylococcus aureus, including Methicillin-Resistant Staphylococcus aureus (MRSA), was the predominant pathogen in sepsis cases.
- Higher incidence of combined septic arthritis and osteomyelitis (88.9% vs 37.5%) and congenital deformities (44.4% vs 0%) were observed in infants with sepsis.
Conclusions:
- Staphylococcus aureus is the primary pathogen in neonatal and infant BJI cases complicated by sepsis.
- Infants with concurrent septic arthritis and osteomyelitis, MRSA infection, or congenital deformities are at increased risk for developing sepsis.
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.
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