title: Bacterial joint infections in England and Wales: analysis of bacterial isolates over a four year period.
abstract: Data from 1158 cases of septic arthritis reported to the Public Health Laboratory Service (PHLS) Communicable Disease Control Centre (CDSC) from England and Wales over a 4 yr period (January 1990 December 1993) are presented. Reports where a bacterial organism was isolated from synovial fluid, or where an organism was isolated from blood cultures where a diagnosis of septic arthritis was reported, were examined. Reports of infection were more common in children (12.7% of infections were in the under 10 age group) and the elderly (54.7% aged 60 or over), and were higher in males in all age groups except in the elderly. The most common causative organisms remain staphylococcal and streptococcal species, comprising 40.6% (470) and 28% (324) of cases, respectively. The most common streptococci seen were Streptococcus pneumoniae and Lancefield group A beta-haemolytic Streptococcus organisms, 60.8% (197/324), although group B, C and G organisms accounted for 33.6% of streptococcal isolates (109/324). Haemophilus influenzae septic arthritis is not exclusive to children as 23.2% (16-69) of cases occurred over the age of 15. A total of 48% (635) of isolates were identified from both synovial fluid and blood cultures, 32.6% (378) from joint fluid alone and 12.5% (146) from blood cultures. Although this study excludes cases of septic arthritis where no organism was isolated, it presents important bacteriological information from a large number of isolates from England and Wales over a 4 yr period. Risk factors identified include a joint prosthesis, joint disease/connective tissue disorder. immunosuppression and diabetes.
authors.affiliation: PHLS Communicable Disease Surveillance Centre, London.
authors.forename: M J
authors.initials: MJ
authors.lastname: Ryan
authors.forename: R
authors.initials: R
authors.lastname: Kavanagh
authors.forename: P G
authors.initials: PG
authors.lastname: Wall
authors.forename: B L
authors.initials: BL
authors.lastname: Hazleman
mesh_terms: D000293:Adolescent; D000368:Aged; D001170:Arthritis, Infectious / Q000453:epidemiology / Q000382:microbiology*; D001424:Bacterial Infections; D002648:Child; D004739:England / Q000453:epidemiology; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007596:Joints / Q000382:microbiology; D008297:Male; D009161:Mycobacterium / Q000302:isolation & purification; D009343:Neisseria / Q000302:isolation & purification; D012307:Risk Factors; D013210:Staphylococcus / Q000302:isolation & purification; D013291:Streptococcus / Q000302:isolation & purification; D013582:Synovial Fluid / Q000382:microbiology; D016896:Treatment Outcome; D014852:Wales / Q000453:epidemiology