title: High Prevalence of Methicillin-Resistant Staphylococcus aureus among Patients with Septic Arthritis Caused by Staphylococcus aureus.
abstract: BACKGROUND
  This study investigated the clinical characteristics of patients with septic arthritis caused by Staphylococcus aureus and tried to identify the risk factors for methicillin-resistant S. aureus (MRSA) arthritis.
  
  
  METHODS
  Between January 2008 and December 2011, patients with septic arthritis caused by S. aureus were identified from the computerized databases of a regional hospital and a medical center in southern Taiwan. The medical records of these patients were retrospectively reviewed.
  
  
  RESULTS
  A total of 93 patients with S. aureus arthritis were identified, and MRSA arthritis was found in 38 (40.9%) cases. The mean age of the patients was 58 years, and 86 (92.5%) episodes were classified as community-acquired infections. Diabetes mellitus (n = 41, 44.1%) was the most common underlying disease, followed by chronic kidney disease and liver cirrhosis. Patients with MRSA arthritis were more frequently elderly and found in the setting of healthcare-associated infection than patients with methicillin-susceptible S. aureus (MSSA) infections. No other significant differences in clinical manifestations and outcomes were noted between these two groups of patients. Overall, the in-hospital mortality rate was 5.4%, and diabetes mellitus was the only risk factor for mortality.
  
  
  CONCLUSIONS
  MRSA is emerging in the setting of community-acquired septic arthritis. MRSA septic arthritis is more likely to develop in the elderly and in healthcare-associated infections than MSSA septic arthritis.
authors.affiliation: Department of Orthopaedics, Chi Mei Medical Center, Tainan, Taiwan; Department of Physical Therapy, Shu Zen Junior College of Medicine and Management, Tainan, Taiwan.
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Lin
authors.affiliation: Department of Orthopaedics, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Chung-Da
authors.initials: CD
authors.lastname: Wu
authors.affiliation: Department of Orthopaedics, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Shun-Chien
authors.initials: SC
authors.lastname: Cheng
authors.affiliation: Department of General Surgery, Chi Mei Medical Center, Liouying, Tainan, Taiwan; Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
authors.forename: Chong-Chi
authors.initials: CC
authors.lastname: Chiu
authors.affiliation: Department of Orthopaedics, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Chi-Chou
authors.initials: CC
authors.lastname: Tseng
authors.affiliation: Department of Orthopaedics, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Huan-Tee
authors.initials: HT
authors.lastname: Chan
authors.affiliation: Department of Orthopaedics, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors.forename: Po-Yih
authors.initials: PY
authors.lastname: Chen
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan; Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan.
authors.forename: Chien-Ming
authors.initials: CM
authors.lastname: Chao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001170:Arthritis, Infectious / Q000453:epidemiology* / Q000382:microbiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009026:Mortality; D063868:Patient Outcome Assessment; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents