title: A retrospective study of septic arthritis in a tertiary hospital in West Texas with high rates of methicillin-resistant Staphylococcus aureus infection.
abstract: Septic arthritis is an important concern for rheumatologists in the evaluation of joint disease. Very few studies have addressed the microbiologic epidemiology and outcomes of septic arthritis in the USA since the year 2000. We performed a retrospective study of septic arthritis in a tertiary hospital in West Texas from the year 2000 to 2013. We recorded data on patient demographics, microbiologic etiology, treatment patterns, and outcomes. The most common causative organisms were Staphylococcus aureus and Streptococcus spp. Methicillin-resistant Staphylococcus aureus (MRSA) caused septic arthritis in 22.6 % of the cases. MRSA septic arthritis was associated with low rates of adequate empiric antimicrobial therapy. The mortality due to sepsis in our study was 5.5 %. Patients with septic arthritis had a mean length of stay of 13.5 ± 12.1 days and required 2.1 ± 1.4 joint operations. Many patients (29.2 %) had readmissions due to complications, and these patients had high rates of home health utilization and transfers to other facilities post hospital discharge. In our logistic regression analysis model, factors associated with poor outcomes in septic arthritis were MRSA, older age, and prosthetic joint infection. Septic arthritis is associated with significant mortality, morbidity, and health care costs, and more studies are needed to improve outcomes, especially considering the increasing rates of MRSA as the pathogen.
authors.affiliation: Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street Bulfinch 165, Boston, MA, 02114, USA, limsianyik@gmail.com.
authors.forename: Sian Yik
authors.initials: SY
authors.lastname: Lim
authors.forename: Deepa
authors.initials: D
authors.lastname: Pannikath
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nugent
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003428:Cross Infection / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008875:Middle Aged; D019637:Orthopedic Procedures; D010359:Patient Readmission; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D062606:Tertiary Care Centers; D013781:Texas / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents