Antibacterial Properties of Synovial Fluid in the Knee

Gruber, Brian F.; Miller, Bruce S.; Onnen, Jeremy; Welling, Rod; Wojtys, Edward M.

doi:10.1055/s-0030-1247816

Cited by 24 publications

(16 citation statements)

References 12 publications

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“…Subcultures of positive BCVs onto blood agar and chocolate agar plates grew the organism without difficulty, indicating that routine bacteriological media support K. kingae's growth requirements. This observation confirms that synovial fluid has potent antibacterial properties (295), exerting an inhibitory effect on K. kingae organisms. Inoculation of the minute exudate sample aspirated from the joint of a young child in a large volume of liquid medium contained in the BCV diluted the noxious effect of the exudate, improving the growth of fastidious K. kingae organisms (17,18).…”

Section: Detection By Culturesupporting

confidence: 80%

Kingella kingae: Carriage, Transmission, and Disease

2015

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SUMMARY Kingella kingae is a common etiology of pediatric bacteremia and the leading agent of osteomyelitis and septic arthritis in children aged 6 to 36 months. This Gram-negative bacterium is carried asymptomatically in the oropharynx and disseminates by close interpersonal contact. The colonized epithelium is the source of bloodstream invasion and dissemination to distant sites, and certain clones show significant association with bacteremia, osteoarthritis, or endocarditis. Kingella kingae produces an RTX (repeat-in-toxin) toxin with broad-spectrum cytotoxicity that probably facilitates mucosal colonization and persistence of the organism in the bloodstream and deep body tissues. With the exception of patients with endocardial involvement, children with K. kingae diseases often show only mild symptoms and signs, necessitating clinical acumen. The isolation of K. kingae on routine solid media is suboptimal, and detection of the bacterium is significantly improved by inoculating exudates into blood culture bottles and the use of PCR-based assays. The organism is generally susceptible to antibiotics that are administered to young patients with joint and bone infections. β-Lactamase production is clonal, and the local prevalence of β-lactamase-producing strains is variable. If adequately and promptly treated, invasive K. kingae infections with no endocardial involvement usually run a benign clinical course.

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Section: Detection By Culturesupporting

confidence: 80%

Kingella kingae: Carriage, Transmission, and Disease

2015

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“…1992; Schneider et al. 1992) and it is recognised that culture of synovial fluid is difficult because of a number of potential factors, such as the sequestration of the bacterium into the synovial membrane (McIlwraith 1983) and the bactericidal qualities of the synovial fluid (DeGara 1943; Gruber et al. 2008).…”

Section: Discussionmentioning

confidence: 99%

Bacterial culture of septic synovial structures of horses: Does a positive bacterial culture influence prognosis?

Taylor¹,

Mair

Smith

et al. 2010

Equine Veterinary Journal

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Fourteen (20.9%) of 67 horses with a positive bacterial culture from synovial fluid were subjected to euthanasia because of persistent synovial sepsis compared to 2 (1.44%) of 139 with negative bacterial cultures (P<0.001). Overall survival and successful long-term return to function in horses with a positive bacterial culture was 50% (24/48 horses) compared to 70.5% (74/105) in culture negative horses (P=0.01). In horses that survived to be discharged, successful long-term return to function was not significantly different between culture positive and culture negative groups. Growth of Staphylococcus aureus from synovial fluid did not affect short-term survival to discharge from the hospital compared to other positive bacterial culture; however, successful long-term return to function was only 30.4% (4/13) in horses from which S. aureus was cultured compared to 73.9% (17/23) of horses in which other bacteria were cultured (P=0.015). CONCLUSIONS AND POTENTIAL CLINICAL RELEVANCE: Horses with a positive bacterial culture from a septic synovitis have a poorer prognosis for survival to discharge from hospital and overall long-term return to function than horses that yielded no bacterial growth. When S. aureus was cultured, the long-term prognosis was poorer.

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“…Upon seeding the synovial membrane, bacteria pass into the joint space. Synovial fluid inhibits S. aureus growth in vitro (464), an observation that is at odds with the substantial damage caused by S. aureus septic arthritis. Several avenues of investigation have clarified this apparent contradiction.…”

Section: Septic Arthritismentioning

confidence: 99%

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

et al. 2015

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SUMMARY Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

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Antibacterial Properties of Synovial Fluid in the Knee

Cited by 24 publications

References 12 publications

Kingella kingae: Carriage, Transmission, and Disease

Kingella kingae: Carriage, Transmission, and Disease

Bacterial culture of septic synovial structures of horses: Does a positive bacterial culture influence prognosis?

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

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