Characteristics of patients with definite septic arthritis at Hamad General Hospital, Qatar: a hospital-based study from 2006 to 2011 (original) (raw)
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Incidence and bacteriologic causes of septic arthritis in a general hospital in Saudi Arabia
Annals of Saudi medicine
Since data on the incidence and etiology of septic arthritis in Saudi Arabia is sparse, we analyzed the incidence and bacterial etiology of septic arthritis in a general hospital in Saudi Arabia. Observational study of all hospitalized patients with native joint septic arthritis from 2005 to 2010. We specifically collected data on demography, joint(s) affected, synovial fluid gram stain and culture, and blood culture. We also included the initial antimicrobial agents, length of stay (LOS) and any surgical interventions. Data were analyzed using simple descriptive statistics. There were 58 cases of native joint septic arthritis with an annual incidence rate of 0.2-0.8 per 1000 discharges. There were 31 (53.4%) males and 27 (46.6%) females with a mean (SD) age of 44.2 (29.3) years. There were 18 (25.8%) children < 18 years of age. The most frequently affected joints were the knee (28, 48.3%), ankle (7, 12.1%), elbow (6, 10.3%), and shoulder (4, 6.9%). Of the synovial cultures, 17 (...
Septic Arthritis and the Proper Use of Antibiotics
BJSTR, 2022
Septic arthritis consists of inflammation of a joint due to a generally bacterial infection, and to a lesser extent fungal or viral. The most commonly affected areas are the knee and hip. Early diagnosis (clinical and microbiological) is essential for the proper treatment of septic arthritis, since it can constitute a medical emergency, given its tendency to joint destruction [1,2]. The fundamental examination consists of the study of synovial fluid, with Gram staining, culture and antibiograma [3-8]. Blood cultures are also recommended, as they are profitable in nongonococcal arthritis, and in the diagnosis of arthritis of axial location, for the difficulty of taking the sample directly. If septic arthritis is suspected, the patient should be admitted, and treatment should be started immediately. Although treatment is variable, it usually focuses on systemic antibiotic administration and drainage of the affected articulation [5,6,9,10]. There is the case of a sanitary woman who, after an accidental puncture with a contaminated needle, develops septic arthritis. In the diagnostic process, the synovial fluid is not examined, and the patient is subjected to numerous changes in antibiotic treatment due to her poor clinical progress. Early diagnosis and proper management of septic arthritis cases is essential in the functional recovery of patients and in the prevention of possible complications [2-8]. Implementing standardized and evidencebased protocols for dealing with septic arthritis can be a very useful tool for healthcare professionals, allowing them to combine criteria and avoid undesirable consequences in the patient [11-19]. Gonococcal arthritis is usually treated for 7-10 days, streptococci or Haemophilus for 2-3 weeks, staphylococcus for 4 weeks and gramnegative bacilli for up to 6 weeks. Treatment should be intravenous for at least the first 2 weeks. Joint prosthesis infection usually requires removal of the prosthesis, cement and necrotic bone. However, if the infection is early (<3 months after implantation of the prosthesis) and the joint is stable, surgical cleaning (without prosthetic replacement) and prolonged antibiotic treatment may be performed (Table 1). There are other types of infectious arthritis, which have a clinical presentation with characteristics such as: gonococcal arthritis, virus, bone tuberculosis, brucellosis, spirochete arthritis [5,6,11,13,19].
Septic arthritis of the knee: clinical and laboratory comparison of groups with different etiologies
Clinics (Sao Paulo, Brazil), 2016
To clinically and epidemiologically characterize a population diagnosed with and treated for septic arthritis of the knee, to evaluate the treatment results and to analyze the differences between patients with positive and negative culture results, patients with Gram-positive and Gram-negative bacterial isolates and patients with S. aureus- and non-S. aureus-related infections. One hundred and five patients with septic knee arthritis were included in this study. The clinical and epidemiological data were evaluated. Statistical analysis was performed to compare patients with and without an isolated causative agent, patients with Gram-positive and Gram-negative pathogens and patients with S. aureus-related and non S. aureus-related infections. Causative agents were isolated in 81 patients. Gram-positive bacteria were isolated in 65 patients and Gram-negative bacteria were isolated in 16 patients. The most commonly isolated bacterium was S. aureus. Comparing cases with an isolated path...
Microbiological Characteristics of Septic Arthritis: A Study from a Tertiary Care Hospital
Microbiology Research Journal International
Background: To determine the epidemiological characteristics, etiological profile, and antimicrobial susceptibility of isolates from patients with primary septic arthritis at a university hospital. Methods: A retrospective study was performed between 2016 and 2017. A review of records was done in the Microbiology Department, and patients with clinical suspicion of septic arthritis whose aspirates were received in the lab were selected for the study. Results: Out of total 216 samples reviewed, 86 showed bacterial growth. Higher joints like knee and hip were more commonly involved and elderly persons were mainly involved (mean age 55 years). Staphylococcus aureus was the most common organism isolated (72%) and Vancomycin and Linezolid showed highest sensitivity. Among gram negative bacteria colistin and meropenem showed highest sensitivity. Conclusions: Septic arthritis in our hospital was primarily acute, and monomicrobial; usually affected higher joints, and S. aureus was main causative agent, and adult patients were usually predisposed to this diseases.
A prospective 2‐year study of 75 patients with adult‐onset septic arthritis
Rheumatology, 2001
Aims and methods. To assess the clinical features of septic arthritis and characterize therapeutic strategies and outcome in a prospective study of 75 patients selected by positive synovial¯uid culture. Results. Underlying joint disease was present in 46 patients, 25 of whom had rheumatoid arthritis and 15 osteoarthritis. Eleven patients were i.v. drug abusers. Fifty-six per cent of cases involved the knee, 15% involved two or more joints, and staphylococci and streptococci were cultured in > 90%. Seventy-eight per cent of patients lived in areas of high social deprivation. Fever was present in 64% and the white cell count (WCC) was normal in 38%. The C-reactive protein was elevated in 98%. Leg ulcers were present in 11% of all patients but in 38% of patients who died (P-0.006). Median duration of antibiotic therapy was 15 days i.v. with subsequent oral treatment for 21 days. Thirty-seven per cent of cases required surgical intervention. Mortality was 11%. A raised WCC at presentation (P-0.02) and the development of abnormal renal function (P-0.015) were predictors of poor prognosis.
Diagnosis of septic arthritis and initial antibiotic treatment
Acta Orthopaedica Et Traumatologica Turcica, 2005
Objectives: This study was designed to determine the similarities and differences in clinical, laboratory and radiographic presentation of septic arthritis in childhood and at adult ages, to find out its etiological profile, and to establish an antibiotic treatment protocol for the initial period and for patients in whom the causative agent could not be identified.
Nigerian Journal of Medicine, 2010
Septic arthritis is an acute bacterial infection of a synovial joint. It is an orthopaedic emergency that can lead to morbidity or mortality if not properly treated. The fundamental issues in the management of septic arthritis include the duration of antibiotic therapy, the mode of joint drainage and the role of physiotherapy. There is paucity of local data on septic arthritis in Nigeria. The study was carried out at the National Orthopaedic Hospital, Enugu; a regional trauma and orthopaedic center with wide catchments area covering at least three geopolitical zones of Nigeria.The objective of the study is to describe the pattern and distribution of non-gonococcal septic arthritis, the causative organisms, and the outcome of management of this condition at Enugu, Nigeria and make recommendations on the antibiotic therapy. A retrospective study of all the patients that presented at the National Orthopaedic Hospital Enugu with Non-gonococcal septic arthritis between January 1997 and December, 2006 was done. The patient's case notes were retrieved from the Medical Record Department. Information extracted and analyzed included demographic data, joints affected, cultured organisms, antibiotic sensitivity pattern, duration of parenteral and oral antibiotics therapy, complications and follow-up period. Patients with incomplete records, immunecompromised patients and those with subjacent osteomyelitis were excluded from the study. Forty-three patients were seen within the period and 40 had analyzable data. The age range was 1 month to 39 years, with a mean age of 10.2 years. Twenty-one patients (52.5%) were males and 19 (47.5%) were females. The hip joint was the most commonly affected (47.5%). Staphylococcus aureus was the most common organism (50%), followed by Coliforms (42.5%). Most patients (75%) had parenteral antibiotics for 3-5 days, while 77.5% of patients received oral antibiotics for 2-4 weeks. All the patients had arthrotomy and joint irrigation within 48 hours of admission. Complications were recorded in 11 patients (27.5%). Fixed flexion deformity was the commonest complication (17.5%). No mortality was recorded. Septic arthritis is an orthopaedic emergency. Early diagnosis and prompt treatment with appropriate antibiotics and surgical drainage are the keys to a successful outcome. In our environment (Enugu), the coliforms are competing favourably with staphylococcus aureus as causative agents of septic arthritis. Short term parenteral antibiotics of 3-5 days seems to be as effective as the 1-2 weeks therapy in the non-immune compromised patients and in cases not complicated by juxtarticular osteomyelitis or presence of prosthetic implants. Septic arthritis, antibiotic therapy, outcome of treatment. Conclusion:
Management of Septic Arthritis in Emergency Department
Journal of Pharmaceutical Research International, 2021
Bacterial arthritis is an inflammation of the joints caused by an infectious etiology, usually bacterial, but there are also fungi, mycobacteria, viruses, or other rare pathogens. Both healthy and predisposed people can be infected. Nongonococcal infectious arthritis, usually a monoarticular disease, affects multiple joints in about 10% of patients and is a new form of septic arthritis. Without treatment, it can progress rapidly and cause irreversible damage to the joints. The overall incidence of bacterial arthritis is 2 to 6 per 100,000, depending on the presence of risk factors. Bacterial arthritis is more common in children than in adults. The incidence of septic arthritis peaks between the ages of 2 and 3 and is predominantly male (2: 1). Most septic joints develop as a result of hematogenous dissemination of the vascular synovium due to bacterial episodes. Osteoarthritis, rheumatoid arthritis, and corticosteroid therapy are the most common predisposing conditions. Typica...