Bacterial arthritis in an English health district: a 10 year review.

Cooper, C.B.; Cawley, M. I. D.

doi:10.1136/ard.45.6.458

Cited by 180 publications

(118 citation statements)

References 24 publications

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“…Underdiagnosis is particularly relevant for gonococcal arthritis where, at best, synovial fluid cultures are positive in only 50 % and blood cultures in only 20% of cases [1,3]. In contrast to other studies over 50 % of our cases of septic arthritis had no previous joint disease or underlying medical illness [2][3][4][5].…”

Section: Discussionmentioning

confidence: 84%

“…Of concern is the delay in presentation of people from remote areas and of Aboriginal males. Such delays have been shown to have a significantly adverse effect on outcomes [1][2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…People living in remote communities took longer to seek medical attention (median 4-0 days) than their urban counterparts (median 2-0 days, P = 0 006). There was no difference in presentation time with respect to the causative organisms S. aureus (median 4-0 days), S. pyogenes (median 2 (Table 1).…”

Section: Epidemiologymentioning

confidence: 96%

“…Septic arthritis is the most serious cause of acute joint inflammation and if not diagnosed and treated promptly can be associated with severe morbidity [1][2][3][4][5][6]. The most common aetiological agents are Staphylococcus aureus, Streptococcus pyogenes and Neisseria gonorrhoeae [1][2][3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…The most common aetiological agents are Staphylococcus aureus, Streptococcus pyogenes and Neisseria gonorrhoeae [1][2][3][4][5][6][7][8][9]. The Previous studies have demonstrated a high incidence of infectious diseases in this region, particularly in Aboriginals [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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An 18 year clinical review of septic arthritis from tropical Australia

et al. 1996

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SUMMARYA retrospective study of 191 cases of septic arthritis was undertaken at Royal Darwin Hospital in the tropical north of Australia. Incidence was 9-2 per 100000 overall and 29 1 per 100000 in Aboriginal Australians (RR 6-6; 95 % CI 5 0-8 9). Males were affected more than females (RR 1 6; 95 % CI 1 2-2 1). There was no previous joint disease or medical illness in 54 %. The commonest joints involved were the knee (54%) and hip (13 %). Significant age associations were infected hips in those under 15 years and infected knees in those over 45 years. Seventytwo percent of infections were haematogenous. Causative organisms included Staphylococcus aureus (37%), Streptococcus pyogenes (16%) and Neisseria gonorrhoeae (12 %). Unusual infections included three melioidosis cases. Polyarthritis occurred in 17%, with N. gonorrhoeae (11/23) more likely to present as polyarthritis than other organisms (22/168) (OR 6-0; 95% CI 2 1-16-7). Univariate and multivariate analysis showed the hip to be at greater risk for S. aureus than other joints. Open arthrotomy was a more successful treatment procedure than arthroscopic washout or needle aspiration.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An 18 year clinical review of septic arthritis from tropical Australia

et al. 1996

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Septic Arthritis of Axial Joints

Zimmerli¹

2015

Bone and Joint Infections

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Septic arthritis

Schurman

1990

Arthritis & Rheumatism

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We report herein that cartilage proteolytic activity increased in bovine and rabbit articular cartilage after treatment with a purified staphylococcal culture medium or intraarticular infection with Staphylococcus aureus. Staphylococcal culture medium increased the release of gelatinolytic, collagenolytic, and caseinolytic activity into the medium of isolated chondrocytes or cartilage organ culture. The proteolytic activities were determined in assays using radiolabeled substrate and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Staphylococcal culture medium was proteolytically inactive by both assay techniques. RNA synthesis of isolated chondrocytes was unaffected by staphylococcal culture medium, whereas overall protein synthesis was inhibited by 84%. An analysis of extracts of Staphylococcus aureus-infected rabbit knee cartilage by substrate gels showed increased gelatinolytic and caseinolytic activity compared with extracts of uninfected knee cartilage. Our data suggest that the rapid loss of proteoglycan and persistent degradation of cartilage in staphylococcal septic arthritis is due to the production and activation of chondrocyte proteases.Septic arthritis continues to be a serious problem in urban medical centers (I ,2) and is recognized as a complicating factor in rheumatoid arthritis and other chronic arthritic conditions (3). Although most joint infections are acquired hematogenously, direct infection can result from deep wounds, surgical procedures, and intraarticular joint injections (2). In nongonococcal septic arthritis, Staphylococcus aureus is the organism most frequently found by culture (64%); in 25% of the patients positive for S aureus, the bacteria are methicillin resistant (1). Sterile "postinfectious" arthritis provides the potential for residual joint damage (43).In an animal model of staphylococcal infectious arthritis, cartilage degradation was shown to continue, despite early antibiotic treatment (5). Infection of rabbit knees with S aureus was shown to cause a rapid loss of cartilage proteoglycan (PG) (a), with a loss of as much as 40% of the total PG from the cartilage matrix within the first 48 hours after infection (8). Loss of collagen becomes significant between the second and third weeks after infection (8). Antibiotic treatment begun within 24 hours of infection decreases collagen loss but fails to prevent loss of PG from the matrix (5).In vitro, S aureus or S aureus-conditioned culture medium induces cartilage degradation in viable cartilage explants (9). Cartilage degradation is marked by a loss of partially degraded PG, which is consistent with increased proteolytic activity. PG release from cartilage by S aureus or staphylococcal culture medium is significantly reduced by freeze-thawing cartilage (9). Killed bacteria have no effect on cartilage degradation. Staphylococcus-induced PG release is dependent on chondrocyte metabolism and can be blocked by inhibitors of RNA and protein synthesis, i.e., actinomycin D and cycloheximide, respectively

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Bacterial arthritis in an English health district: a 10 year review.

Cited by 180 publications

References 24 publications

An 18 year clinical review of septic arthritis from tropical Australia

An 18 year clinical review of septic arthritis from tropical Australia

Septic Arthritis of Axial Joints

Septic arthritis

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