Septic arthritis of the knee: clinical and laboratory comparison of groups with different etiologies (original) (raw)
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Clinics (São Paulo, Brazil), 2015
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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.
Clinical Rheumatology, 2013
The aim of this retrospective study, was to determine the epidemiological and clinical characteristics, co-existing conditions, causative organisms and outcome of all adult patients 15 years of age or older who had definite septic arthritis seen at Hamad general hospital, Qatar from 2006 to 2011. During this period, 56 patients were diagnosed with septic arthritis with a mean age (±SD) of 49.0 ±16.6 years. In 53/56 (94.6%) patients, arthritis was diagnosed in a single joint while polyarthritis was diagnosed in 3/56 (5.4%) and the commonest joint involved was the knee 40/59 (67.7%). The most frequent coexisting condition was diabetes mellitus 24/56 (42.8%), while joint pain and restriction of movement were reported by all patients. Gram positive bacteria accounted for 36/57 (63.0%) of all isolated microorganisms, and Staphylococcus aureus was the commonest pathogen 20/57 (35.0 %). Three cases of tuberculous arthritis were seen. The most favored antibiotic combinations were cloxacillin/ciprofloxacin; cefazolin/ciprofloxacin and vancomycin/ciprofloxacin. Repeated needle aspirations were used in 18/56 (32.1%) patients and open drainage of the joints was performed on 22/56 (39.3%) patients, while
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 (...
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:
Risk Factors, Screening, and Treatment Challenges in Staphylococcus aureus Native Septic Arthritis
Open Forum Infectious Diseases, 2021
Background Staphylococcus aureus is the most common cause of native septic arthritis. Few studies have characterized this disease during the US opioid epidemic. The role of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening in this disease has not been elucidated. We sought to identify risk factors and outcomes for S. aureus native septic arthritis and to evaluate MRSA screening in this disease. Methods A retrospective cohort study of native septic arthritis patients (2012–2016) was performed. Demographics, risk factors, and outcomes were compared between Staphylococcus aureus and other native septic arthritis infections. Sensitivity, specificity, and predictive values of MRSA screening were assessed. Results Two hundred fifteen cases of native septic arthritis were included. S. aureus was cultured in 64% (138/215). MRSA was cultured in 23% (50/215). S. aureus was associated with injection drug use (odds ratio [OR], 4.33; 95% CI, 1.74–10.81; P = .002) and switching a...
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].