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. 2020 Dec;52(4):503-515.
doi: 10.3947/ic.2020.52.4.503.

Clinical Characteristics and Causative Pathogens of Infective Arthritis and Risk Factors for Gram-Negative Bacterial Infections

Yongseop Lee  1 , Yun Suk Cho  1 , Yu Jin Sohn  1 , Jong Hoon Hyun  1 , Sang Min Ahn  1 , Woon Ji Lee  1   2 , Jung Ho Kim  1   2 , Hye Seong  1   2 , Junhyoung Kim  1   2 , Su Jin Jeong  1   2 , Nam Su Ku  1   2 , Joon Sup Yeom  1   2 , Jin Young Ahn  1   2 , Jun Yong Choi  1   3
Affiliations

Clinical Characteristics and Causative Pathogens of Infective Arthritis and Risk Factors for Gram-Negative Bacterial Infections

Yongseop Lee et al. Infect Chemother. 2020 Dec.

Abstract

Background: The aim of this study was to describe the clinical and microbiological characteristics of infective arthritis and to analyze risk factors for Gram-negative bacterial infections that cause infective arthritis.

Materials and methods: Patients admitted between 2009 - 2018 with infective arthritis in a single-tertiary hospital were evaluated retrospectively.

Results: A total of 181 patients were enrolled in this study. Of them, 135 were native joint infection patients and 46 were prosthetic joint infection patients. The most common site of infective arthritis was the knee (63.6%), followed by the shoulder (17.7%), and the hip (9.9%). The most frequently identified microorganisms were Staphylococcus aureus (51.1%), followed by Streptococci sp. (21.1%), Enterobacteriaceae (8.4%), and coagulase-negative-Staphylococci (CNS; 8.4%). Infections due to Gram-negative bacteria and fungi made up 13.7% and 3.2% of all cases, respectively. Additionally, 20% and 4.2% of the cases involved methicillin-resistant S. aureus (MRSA) and MRCNS. We found that bacteriuria, infective arthritis in the hip, and steroid use at admission are independent risk factors for Gram-negative bacterial infections.

Conclusion: Infective arthritis with methicillin-resistant microorganisms reached up to about 25% in a single-tertiary hospital in Korea. In case of suspected urinary tract infection, infective arthritis of the hip joint, or steroid use at admission time among infective arthritis patients, empirical treatment covering Gram-negative microorganisms can be considered.

Keywords: Arthritis, infectious; Gram-negative bacterial infections; Methicillin resistance; Risk factors.

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Conflict of interest statement

No conflict of interest.

Figures

Figure 1
Figure 1. Site of infected joint.
Figure 2
Figure 2. Distribution of causative microorganisms according to the site of infected joints.
MSSA, methicillin-sensitive Staphylococcus aureus; MRSA, methicillin-resistant Staphylococcus aureus; MSCNS, methicillin-sensitive coagulase-negative Staphylococci; MRCNS, methicillin-resistant coagulase-negative Staphylococci; Other G+, other Gram-positive microorganisms; Other G-, other Gram-positve microorganisms.
See this image and copyright information in PMC

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