Clinical manifestations and bacteriological features of culture-proven Gram-negative bacterial arthritis

Lin, Wei−Ting; Tang, Hung‐Jen; Lai, Chih‐Cheng; Chao, Chien‐Ming

doi:10.1016/j.jmii.2015.08.026

Cited by 11 publications

(10 citation statements)

References 10 publications

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“…Full-text screening excluded an additional 5 articles, providing an evidence base of 87 studies (figure 1). 10–96 The 87 studies included in the qualitative analysis were conducted between 1991 and 2017 in 25 countries, mainly in South Korea (14 studies), Thailand (7), USA (7), Taiwan (7) and Spain (7). Sixty (68.9%) studies were performed in HICs, 26 (29.9%) in LMICs and 1 included both HICs and LMICs 56.…”

Section: Resultsmentioning

confidence: 99%

Variation of effect estimates in the analysis of mortality and length of hospital stay in patients with infections caused by bacteria-producing extended-spectrum beta-lactamases: a systematic review and meta-analysis

Shamsrizi

Gladstone

Carrara³

et al. 2020

BMJ Open

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ObjectiveTo assess the variation of effect estimates in the analysis of mortality and length of stay (LOS) in patients with infections caused by extended-spectrum beta-lactamase (ESBL)-producingEnterobacteriaceae.DesignSystematic review and meta-analysisMethodsLiterature search for clinical studies from 1 January 1960 to 1 October 2018 was conducted in PubMed. Primary outcomes were risk ratios (RRs) of all-cause and attributable mortality and weighted mean differences (WMDs) in LOS in patients with bloodstream infections (BSIs) and non-invasive infections. Any change in the effect estimates was assessed by grouping studies according to design, setting, economy-based country classification, reporting period, microbiological aetiology, infection type and adjustment for appropriateness of empirical treatment. The impact of ESBL production was calculated using random-effect meta-analysis and heterogeneity was evaluated by I2statistics and metaregression.ResultsEighty-four studies including 22 030 patients and 149 outcome measures were included in the meta-analysis. Most studies were retrospective cohorts from high-income countries, providing unadjusted estimates. ESBL production in patients with BSIs (56 studies) increased the RR for all-cause mortality by a factor of 1.70 (95% CI 1.52 to 1.90; p<0.001), attributable mortality (16 studies) by 1.75 (95% CI 1.448 to 2.108; p<0.001) and WMD in the intensive care unit by 3.07 days (95% CI 1.61 to 4.54; p<0.001). WMD in hospital LOS was significantly higher in BSIs (4.41 days; 95% CI 3.37 to 5.46; p<0.001) and non-invasive (2.19 days; 95% CI 1.56 to 2.81; p<0.001). Subgroup analyses showed variation of estimates by study design, population, strain and assessment of appropriateness of empiric treatment. High heterogeneity was observed in all analyses.ConclusionsCurrent evidence of the clinical burden of infections caused by ESBL-producing bacteria is highly heterogeneous and based mainly on unadjusted estimates derived from retrospective studies. Despite these limitations, ESBL production in strains causing BSIs seems associated with higher all-cause and attributable mortality and longer hospitalisation.

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Section: Resultsmentioning

confidence: 99%

Variation of effect estimates in the analysis of mortality and length of hospital stay in patients with infections caused by bacteria-producing extended-spectrum beta-lactamases: a systematic review and meta-analysis

Shamsrizi

Gladstone

Carrara³

et al. 2020

BMJ Open

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“… 24 The high CFR in patients with septic arthritis and concomitant bacteremia is also consistent with the previous findings. 25 , 26 …”

Section: Discussionmentioning

confidence: 99%

Clinical Epidemiology of Septic Arthritis Caused by Burkholderia pseudomallei and Other Bacterial Pathogens in Northeast Thailand

Teparrukkul

Nilsakul

Dunachie

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Abstract.Septic arthritis is a medical emergency, and if not treated appropriately, it can be associated with high morbidity and mortality. Melioidosis, a serious infectious disease caused by the Gram-negative bacillus Burkholderia pseudomallei, is highly endemic in South and Southeast Asia and northern Australia. We reviewed the medical charts of adult patients admitted with bacterial septic arthritis at Sunpasitthiprasong Hospital, Ubon Ratchathani, northeast Thailand from January 2012 to December 2014. Bacterial septic arthritis was defined as one or more hot swollen joints with isolation of a pathogenic organism from an affected joint or from blood. A total of 154 patients with septic arthritis were retrospectively evaluated. The most common causes were B. pseudomallei (48%, N = 74), Streptococcus spp. (29%, N = 44), and Staphylococcus aureus (10%, N = 16). Prevalence of diabetes, bacteremia, and pneumonia was higher in B. pseudomallei septic arthritis than in septic arthritis caused by the other bacteria (all P < 0.01). Seventy three percent (54/74) of patients infected with B. pseudomallei and 69% (55/80) of patients with the other bacteria received effective antimicrobials on the first day of admission (P = 0.60), but in-hospital mortality of the former group was considerably higher (34% versus 14%, P = 0.004). In conclusion, B. pseudomallei septic arthritis is common and associated with high mortality in northeast Thailand. Emergence of Streptococcus arthritis is observed. Difficulty in diagnosing melioidosis and identifying B. pseudomallei in areas where health care workers are not familiar with the disease is discussed. In melioidosis-endemic regions, parenteral ceftazidime could be considered as empirical antimicrobial therapy for patients with septic arthritis and underlying diseases.

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“…It has been reported that longer treatment duration is necessary because treatment response is lower and complications such as ankylosis, secondary osteomyelitis, flexion contracture, chronic effusion, and recurrent infections are more common [10,11] . Septic arthritis due to Gram-negative bacilli in immunocompetent patients is rare, and has been reported in the literature as case reports or case series [10,11,[14][15][16][17] . Lin et al [14] reported in a series of 194 septic arthritis cases of which 48 (24.7%) were due to Gramnegative bacteria.…”

Section: Discussionmentioning

confidence: 99%

“…Septic arthritis due to Gram-negative bacilli in immunocompetent patients is rare, and has been reported in the literature as case reports or case series [10,11,[14][15][16][17] . Lin et al [14] reported in a series of 194 septic arthritis cases of which 48 (24.7%) were due to Gramnegative bacteria. In the same series, 56.3% of the patients had at least one underlying immunosuppressive condition, 29.2% had gut disease, and 62.5% were over 65 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…The authors pointed out the rapid and destructive progression to amputation despite the treatment with kanamycin, to which the infecting strain was susceptible [13] . In the literature, this agent is usually reported in patients with nosocomial infection or severe immunosuppression [13][14][15][16] . Epidemic S. marcescens arthritis was first reported by Nakashima et al [17] as an iatrogenic infection in ten patients using contaminated benzalkonium chloride antiseptic agent.…”

Section: Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Posttraumatic Septic Arthritis Due to Serratia marcescens: Case Report and Review of Literature

Olut¹,

Tosun²,

Arı³

et al. 2018

mjima

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Septic arthritis is classified among the acute emergencies of joint diseases. Gram-positive cocci are responsible in 75-80% of the cases, while Gramnegative bacilli may be the etiological agents in case of compromised immunity, intravenous drug abuse, advanced age, or iatrogenic infections. Cases of posttraumatic septic arthritis due to Gram-negative bacilli in immunocompetent patients are reported in the literature. In this paper we present a severe septic arthritis due to Serratia marcescens in a 43-year-old man with multiple trauma, right patellar and femoral condyle fracture after a traffic accident, three days after an irrigation and debridement procedure was performed. The surgical procedure had to be repeated four times while he was receiving medical treatment. A literature search in PubMed using the keywords "Serratia marcescens and septic arthritis" on October 10 th 2017, we found 37 articles, of which 18 were case reports or case series. Of those 18 articles, seven cases were hospital-acquired, five were in intravenous drug users, two were trauma related, one was concomitant with rheumatoid arthritis, one was in a neonate, one was due to intra-articular injection, and one article described an epidemic due to usage of contaminated benzalkonium chloride solution as an antiseptic. We also found a case by searching Turkish Medline reported in a ten-week-old baby with Escobar syndrome. In our case, although hospital-acquired infection cannot be ruled out, we believe that this was a community-acquired infection due to contamination of the open dirty wound, as the irrigation procedure was done in sterile operating room conditions and no other such case has ever been identified. As prompt diagnosis and treatment is critical in prognosis of septic arthritis, we emphasize the possible role of Gram-negative bacilli in posttraumatic cases. Keywords: Septic arthritis, Serratia marcescens, posttraumatic, generic antibiotics, ertapenem Septik artrit, eklemle ilgili acil hastalıklar arasında sınıflandırılır. Erken tanı ve tedavi prognoz açısından oldukça önem taşır. Tüm olgularda en sık görülen etkenler %75-80 oranında Gram-olumlu koklardır. Ancak immün yetmezlik, damar içi ilaç alışkanlığı, ileri yaşlar veya iyatrojenik olgularda Gram-olumsuz basiller de etken olabilirler. Literatürde immünkompetan hastalarda da travma sonrası gelişen Gram-olumsuz basillere bağlı artritler bildirilmektedir. Bu yazıda trafik kazası sonucu multitravma, sağ patella ve sağ femoral kondil kırığı ile başvuran 43 yaşındaki erkek olguda debridman ve yıkama işlemi sonrasında üçüncü gün gelişen, Serratia marcescens'e bağlı şiddetli septik artrit olgusu sunulmuştur. Antibiyoterapi alırken cerrahi yıkama işleminin biri açık artrotomi olmak üzere dört kez tekrarlanması gerekmiştir. PubMed'de 10 Ekim 2017'de anahtar kelime olarak "Serratia marcescens ve septic arthritis" kullanılarak yapılan taramada 37 adet makale bulunmuş ve olgu bildiren 18 makale incelenmiştir. Makalelerin yedisi hastane kaynaklı, beşi damar içi ilaç alışkanlığı, ikisi travmay...

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Clinical manifestations and bacteriological features of culture-proven Gram-negative bacterial arthritis

Abstract: Approximately 25% of cases of septic arthritis were due to GNB and resistance to commonly used antimicrobial agents was common. Liver cirrhosis and concomitant bacteremia were significant risk factors for death.

Cited by 11 publications

References 10 publications

Variation of effect estimates in the analysis of mortality and length of hospital stay in patients with infections caused by bacteria-producing extended-spectrum beta-lactamases: a systematic review and meta-analysis

Variation of effect estimates in the analysis of mortality and length of hospital stay in patients with infections caused by bacteria-producing extended-spectrum beta-lactamases: a systematic review and meta-analysis

Clinical Epidemiology of Septic Arthritis Caused by Burkholderia pseudomallei and Other Bacterial Pathogens in Northeast Thailand

Posttraumatic Septic Arthritis Due to Serratia marcescens: Case Report and Review of Literature

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