Neonatal osteomyelitis.

To evaluate current conservative therapy and document the existence of a recent shift in etiologic agents, we reviewed the records of 45 infants who developed osteomyelitis within the first ten weeks of life and who were admitted to Babies Hospital (New York) from 1951 through 1976. Emphasis was placed on characteristics and course of the disease, etiologic agents, therapy, and outcome. Illness was diagnosed within the first two weeks of life in 34 of the 45 infants (73%). Only six had been delivered normally after normal pregnancy and led a normal life before development of ostemyelitis. Infected sites were distinctive in frequency of involvement of multiple foci (21), of facial bones (10), and of joints contiguous to infected long bones (22 of 29). Conservative therapy (nonsurgical) seems reasonable for the majority of patients. Of particular interest is documentation of a shift from Staphylococcus aureus as predominant etiologic agent before 1965 to beta-hemolytic streptococci, commonly group B, from 1965 through 1976. Data collected from the literature of the 1930s indicate that such shifts have occurred before.