Clinical and epidemiological differences between septic arthritis of the knee and hip caused by oxacillin-sensitive and -resistant s. aureus

Helito, Camilo Partezani; Zanon, Bruno Bonganha; Miyahara, Helder de Souza; Pécora, José Ricardo; Lima, Ana Lúcia Munhoz; Oliveira, Priscila Rosalba de; Vicente, José Ricardo Negreiros; Demange, Marco Kawamura; Camanho, Gilberto Luís

doi:10.6061/clinics/2015(01)06

Cited by 10 publications

(10 citation statements)

References 24 publications

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“…The most common causative agent associated with septic arthritis is S. aureus , which accounts for about 50% of cases [ 43 ]. Recently, an increase in methicillin-resistant S. aureus (MRSA) infections has been reported in several health-care systems, particularly in the elderly and intravenous drug abuser populations as well as in patients who underwent orthopedic procedures [ 44 ]. MRSA has been associated with 18% and 41% of septic arthritis cases in studies in São Paulo, Brazil and Tainan, Taiwan, respectively [ 44 , 45 ].…”

Section: Septic Arthritismentioning

confidence: 99%

“…Recently, an increase in methicillin-resistant S. aureus (MRSA) infections has been reported in several health-care systems, particularly in the elderly and intravenous drug abuser populations as well as in patients who underwent orthopedic procedures [ 44 ]. MRSA has been associated with 18% and 41% of septic arthritis cases in studies in São Paulo, Brazil and Tainan, Taiwan, respectively [ 44 , 45 ]. Other bacteria such as group B streptococci, Streptococcus pneumoniae , Neisseria gonorhoeae , Pseudomonas aeruginosa , Escherichia coli , Proteus genus and Klebsiella species can be associated with septic arthritis, but are less frequent [ 46 ].…”

Section: Septic Arthritismentioning

confidence: 99%

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Neutrophils: Beneficial and Harmful Cells in Septic Arthritis

Boff

Crijns

Teixeira

et al. 2018

IJMS

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Septic arthritis is an inflammatory joint disease that is induced by pathogens such as Staphylococcus aureus. Infection of the joint triggers an acute inflammatory response directed by inflammatory mediators including microbial danger signals and cytokines and is accompanied by an influx of leukocytes. The recruitment of these inflammatory cells depends on gradients of chemoattractants including formylated peptides from the infectious agent or dying cells, host-derived leukotrienes, complement proteins and chemokines. Neutrophils are of major importance and play a dual role in the pathogenesis of septic arthritis. On the one hand, these leukocytes are indispensable in the first-line defense to kill invading pathogens in the early stage of disease. However, on the other hand, neutrophils act as mediators of tissue destruction. Since the elimination of inflammatory neutrophils from the site of inflammation is a prerequisite for resolution of the acute inflammatory response, the prolonged stay of these leukocytes at the inflammatory site can lead to irreversible damage to the infected joint, which is known as an important complication in septic arthritis patients. Thus, timely reduction of the recruitment of inflammatory neutrophils to infected joints may be an efficient therapy to reduce tissue damage in septic arthritis.

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Section: Septic Arthritismentioning

confidence: 99%

Section: Septic Arthritismentioning

confidence: 99%

Neutrophils: Beneficial and Harmful Cells in Septic Arthritis

Boff

Crijns

Teixeira

et al. 2018

IJMS

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“…The only analyzed parameter that differed significantly was the patient history in that a history of a health service-related environmental encounter was associated with infection due to S. aureus. The growing incidence of methicillin-resistant S. aureus likely explains these findings 19. Some authors have suggested that in patients relating a health service environmental exposure, vancomycin or teicoplanin should be considered the first-choice empirical antibiotics 19.…”

Section: Discussionmentioning

confidence: 99%

“…The growing incidence of methicillin-resistant S. aureus likely explains these findings 19. Some authors have suggested that in patients relating a health service environmental exposure, vancomycin or teicoplanin should be considered the first-choice empirical antibiotics 19. Patients with S. aureus -related infections also tended to have higher CRP values and shorter intervals between symptom onset and the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Septic arthritis of the knee: clinical and laboratory comparison of groups with different etiologies

Helito¹,

Teixeira²,

Oliveira³

et al. 2016

Clinics

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OBJECTIVES: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.METHODS: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.RESULTS: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 pathogen to cases without an isolated pathogen, no differences between the studied variables were found except for the longer hospital stays of patients in whom an etiological agent was identified. When comparing Gram-positive bacteria with Gram-negative bacteria, patients with Gram-positive-related infections exhibited higher leukocyte counts. Patients with S. aureus-related infections were more frequently associated with healthcare-related environmental encounters.CONCLUSION:S. aureus is the most common pathogen of septic knee arthritis. Major differences were not observed between infections with isolated and non-isolated pathogens and between infections with Gram-positive and Gram-negative bacteria. S. aureus infections were more likely to be associated with a prior healthcare environment exposure.

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“…A systematic review by Vardakas et al found that CA-MRSA bone and joint infections mainly affect patients younger than 2 years of age and African Americans e the reasons for this are not clear and it may be related to access to care or atypical presentations of bone and joint infections in very young children [19]. For patients with septic arthritis of the hip or knee, if a patient were from a health-service-related environment, this was associated with an infection by MRSA more than that of a methicillin-sensitive S. aureus [20].…”

Section: Microbiologymentioning

confidence: 97%