Clinical characteristics of patients with polymicrobial septic arthritis

Futterman, Orit; Lieber, Sarah B.; Nasrullah, Kunwal; Fowler, Mary Louise; Shmerling, Robert H.; Paz, Ziv

doi:10.1007/s10096-019-03557-4

Cited by 4 publications

(6 citation statements)

References 10 publications

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“…In this case, P. micra and F. nucleatum were identified as pathogens of septic arthritis. The most prevalent pathogens causing polymicrobial septic arthritis are coagulase-negative S. aureus (31% of cases), followed by methicillin-sensitive S. aureus (29%) and Enterococcus (24%) ( 6 ). Polymicrobial anaerobic infection with P. micra and F. nucleatum is rare in bone and soft tissue infections and has been reported in spinal discitis ( 7 ) as well as osteomyelitis of the thumb's distal phalanx ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, P. micra and F. nucleatum have been reported to show synergistic effects of biofilm formation, and these effects may be crucial for colonization in apical periodontitis lesions ( 9 ). Although such cases are relatively rare, patients with polymicrobial septic arthritis tend to be sicker and have greater shock rates, more frequent intensive-care unit admissions, and longer mean stays than monomicrobial septic arthritis ( 6 ). Therefore, appropriate early treatment is essential to prevent serious complications of sternoclavicular septic arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…As treatment, we selected ampicillin/sulbactam as the initial treatment for three reasons. First, the most common pathogens in the polymicrobial septic arthritis are coagulase-negative S. aureus , methicillin-sensitive S. aureus and Enterococcus , as discussed above ( 6 ). Second, abscesses that occur due to the introduction of normal flora into normally sterile body sites are often polymicrobial ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

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Sternoclavicular Septic Arthritis Caused by Parvimonas micra and Fusobacterium nucleatum Infection with Intra-articular Corticosteroid Administration

2024

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Sternoclavicular septic arthritis is a rare form of septic arthritis that can lead to fatal complications, such as abscess formation and mediastinitis, in the absence of prompt diagnosis and appropriate treatment. A man in his 40s presented with pain in the right sternoclavicular joint area, and after a joint injection of steroids was administered, he was diagnosed with septic sternoclavicular arthritis caused by Parvimonas micra and Fusobacterium nucleatum . Gram staining of a specimen obtained from the abscess formation area led to early suspicion of anaerobic infection, and appropriate antibiotics were administered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Sternoclavicular Septic Arthritis Caused by Parvimonas micra and Fusobacterium nucleatum Infection with Intra-articular Corticosteroid Administration

2024

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“…Treating these patients may require multiple operations and cultures to finalize a definitive antibiotic regimen, which is critical as these patients tend to present sicker and ultimately have worse outcomes. [10] In 2012, the U.S. had 13,714 hospitalizations with septic arthritis as the primary diagnosis. The total hospital charges were $759 million.…”

Section: Financial Support and Sponsorshipmentioning

confidence: 99%

Repeat cultures in septic arthritis, do they change antibiotic management?

Judy

Girgis

Sewards

2022

JMSR

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Objectives: Septic arthritis is an orthopedic surgical emergency. Repeat cultures increase cost and patient discomfort; however, it is unknown whether repeat cultures have any merit in guiding treatment. The primary purpose of this investigation is to determine if repeat septic arthritis synovial fluid cultures alter antibiotic management. The secondary purpose is to identify independent risk factors that may alter subsequent antibiotic therapy. Methods: Septic arthritis cases were retrospectively reviewed using the International Classification of Diseases, Ninth Revision codes between January 2011 and December 2015. Inclusion criteria were patients >18 years with >1 positive synovial culture taken >2 days apart. Results: Two hundred and ninety-two synovial cultures were taken. Seventy were repeat cultures. Around 3 quarters (74.3%) yielded the same bacteria and 25.7% yielded different bacteria. Less than half (45.7%) of repeat cultures were associated with a change in antibiotics. Of the 18 repeat cultures that yielded different bacteria, six repeat cultures contained the same bacteria ± a different organism. Thirteen of the eighteen repeat cultures with different bacteria required a change in antibiotics. Patients who had their antibiotic therapy changed after repeat cultures were more likely to have diabetes mellitus (66.7% vs. 38.5%; P = 0.04, OR = 3.2 [1.04, 9.89]). Patients with hepatitis C more frequently required a different antibiotic regimen on repeat cultures (69.2% vs. 40.4%; P = 0.06, OR = 3.3 [0.91, 12.1]). Conclusion: Repeat culture data in patients with septic arthritis changed antibiotic regimens in 45.7% of patients and yielded different bacteria in 25.7%. Patients with diabetes more frequently required alternate antibiotic regimens.

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“…Arthroscopic surgery and intra-articular injections represent two associated risk factors [2,3]. Polymicrobial etiology is uncommon, with the presence of coagulase-negative staphylococci (CNS) and Staphylococcus aureus, as the main microorganisms involved [4]. In turn, anaerobic bacteria are less common and are related to septic arthritis located in small joints, such as the wrist [5].…”

Section: Sirmentioning

confidence: 99%