The profile of the causative organisms which lead to septic arthritis of native joints over the last two decades in a single tertiary medical center in the east coast of the United States

Abstract

Background: Septic arthritis (SA) is associated with significant morbidity and mortality. Delayed or inadequate treatment may result in joint destruction, osteomyelitis and sepsis. Like other types of infection, the causative agents of SA may have changed over time. Early targeted intervention is important in cases of SA and can be achieved only by understanding the current trends in the microbiology of SA.Objectives: To determine the trends in the microbiology of SA over the last two decades. Methods:We conducted a retrospective study including all patients 18 and older with culture positive, surgically treated, native joint septic arthritis (NJSA), admitted to a single tertiary medical centre in Boston between the years of 1997 and 2015.We excluded cases of osteomyelitis and septic bursitis. We focused our analysis on the microbiology data which included synovial fluid gram stain and culture, blood cultures and synovial biopsy cultures. How to cite this article: Arieli MM, Fowler ML, Lieber SB, Shmerling RH, Paz Z. The profile of the causative organisms which lead to septic arthritis of native joints over the last two decades in a single tertiary medical center in the east coast of the United States.

Epidemiology and outcomes of bone and joint infections in solid organ transplant recipients

“…Most BJI were due to Gram‐positive cocci, followed by aerobic Gram‐negative bacilli, consistent with data in the general population 18,28–35 . Overall, S. aureus , Streptococcus spp.…”

“…Most BJI were due to Gram‐positive cocci, followed by aerobic Gram‐negative bacilli, consistent with data in the general population. 18 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 Overall, S. aureus , Streptococcus spp. and Enterobacterales represented the vast majority of pathogens identified.…”

Clinical Characteristics and In-Hospital Outcomes in Dialysis Patients with Septic Arthritis

“…The causative organisms in this study were predominantly Gram-positive bacteria, with S. aureus and Streptococci attributable for more than 80% of these cases. MRSA was accountable for septic arthritis in more than half of the patients with bacteremia (58.3%) and in almost half of the patients who had positive synovial fluid cultures (47.6%)—both of these prevalence rates were higher than that of the general population [ 4 , 28 , 29 ]. The incidence rate of MRSA infection in dialysis patients in this study is noticeably higher than the rates reported in septic arthritis studies with or without dialysis status [ 9 , 29 , 30 ].…”

“…Common locations for septic arthritis include shoulders, hips, and knee joints, all involving metaphyses with ample blood supply, which leads to the proclivity for bacterial infection [ 3 ]. The most frequently identified causative organism in septic arthritis is Staphylococcus aureus ( S. aureus ), followed by methicillin-resistant S. aureus (MRSA), Group B Streptococcus , and Gram-negative organisms [ 4 , 5 ]. The risk factors for the development of septic arthritis include an age greater than 80 years, diabetes mellitus, rheumatoid arthritis, recent joint surgery, hip or knee prosthesis and/or skin infection, and human immunodeficiency virus type-1 infection as suggested by meta-analysis research [ 6 ].…”