Characteristics of patients with definite septic arthritis at Hamad General Hospital, Qatar: a hospital-based study from 2006 to 2011

Abstract

The aim of this retrospective study was to determine the epidemiological and clinical characteristics, coexisting conditions, causative organisms, and outcomes of all adult patients 15 years of age or older who had definite septic arthritis at Hamad General Hospital, Qatar, from 2006 to 2011. During this period, 56 patients were diagnosed with septic arthritis (mean age ± SD, 49.0 ± 16.6 years). In 53 of 56 (94.6%) patients, arthritis was diagnosed in a single joint, while polyarthritis was diagnosed in 3 of 56 (5.4%) patients; the most commonly involved joint was the knee (40 of 59 joints, 67.7%). The most frequent coexisting condition was diabetes mellitus (24 of 56 patients, 42.8%). Joint pain and restriction of movement were reported by all patients. Gram-positive bacteria accounted for 36 of all 57 (63.0%) isolated microorganisms, and Staphylococcus aureus was the most common pathogen (20 of 57 microorganisms, 35.0%). Three cases of tuberculous arthritis were seen. The most favored antibiotic combinations were cloxacillin/ciprofloxacin, cefazolin/ciprofloxacin, and vancomycin/ciprofloxacin. Repeated needle aspiration, open joint drainage, and arthroscopic techniques were performed in 18 (32.1%), 22 (39.3%), and 11 (19.6%) of the 56 patients, respectively. The 30-day mortality was 3.6%, and the remaining patients showed clinical improvement upon discharge. In conclusion, there was no specific sign or symptom for diagnosing septic arthritis. Isolation of bacteria from the synovial fluid confirmed the diagnosis, and S. aureus and streptococci were the most common pathogens isolated. Prompt treatment with appropriate antibiotics and synovial drainage are mandatory to improve the outcome.

Pyogenic arthritis of native joints in non-intravenous drug users: A detailed analysis of 268 cases attended in a tertiary hospital over a 22-year period

“…Importantly, we only included patients with pyogenic infection of native joints; we excluded both patients with prosthetic joints and also IVDUs, who represented 13% of patients during the study period. These aspects should be borne in mind when comparing our results with earlier more heterogeneous reports [5][6][7][8][9][10][11][12] published over the last 2 decades ( Table 7). As expected, our findings support the assertion that pyogenic arthritis in drug addicts presents with particular features that require a different approach.…”

“…In addition, our results outline the opportunistic nature of the disease [5,8,11,12]; the medical conditions most frequently associated with pyogenic arthritis in our patients were chronic liver disease, chronic renal failure, rheumatoid arthritis and especially diabetes mellitus and malignancy.…”

“…Nevertheless, these are based on heterogeneous populations of patients with prosthetic joint infection [8,[10][11][12], arthritis due to non-pyogenic microorganisms [5,6,8,12], and arthritis without a bacteriological diagnosis [9,10,12]. Moreover, some reports [9,11,12] have failed to distinguish between IVDUs and non-drug users and others include a scarce number of patients [6,7].…”

“…In the last years, several reported series [5][6][7][8][9][10][11][12] have analyzed the clinical and microbiological features of infectious arthritis and have increased our knowledge and understanding of this disease. Nevertheless, these are based on heterogeneous populations of patients with prosthetic joint infection [8,[10][11][12], arthritis due to non-pyogenic microorganisms [5,6,8,12], and arthritis without a bacteriological diagnosis [9,10,12].…”

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

“…aureus is the most common pathogen in all three major classes of osteoarticular infection, namely, osteomyelitis (OM) (382)(383)(384)(385)(386)(387)(388)(389)(390)(391)(392), native joint septic arthritis (393)(394)(395)(396)(397)(398)(399)(400)(401), and prosthetic joint infection (PJI) (402)(403)(404)(405)(406). As staphylococcal osteoarticular infections in children are common and have distinctive clinical and management issues compared to those in adults, we include an in-depth discussion of this important subpopulation.…”