The Management of Patients with Acute Septic Arthritis: An Epidemiological Study

Abstract

Aim: The aim of this study is to evaluate the causative agents, diagnosis, treatment, and outcomes of acute septic arthritis cases. Material and Methods: In this retrospective, single-center study, patients over 18 years of age diagnosed with acute septic arthritis were searched from the hospital database between January 2015 and April 2021. Demographic characteristics, diagnostic procedures, therapeutic management, and outcomes were recorded. Results: A total of 59 patients and 60 septic joints were included in the study. The causative microorganisms were isolated in 52.54% of the cases. Staphylococcus aureus grew in 70.96% of the cases and among these, 31.82% were methicillin-resistant. The most frequently affected body part was the knee (73.33%). The cases were found to have fever at a rate of 42.37%. Diabetes was the most common comorbidity (30.51%), and immunosuppression was found in 39% of the cases. Arthrotomy was the most commonly used surgical method for the management of septic arthritis (43.55%). The mortality rate was 6.78%. The cases were categorized as groups with and without microorganisms isolated in culture. When these two groups were compared, no statistically significant difference was found except for the duration of hospitalization (p=0.001). Conclusion: Septic arthritis should be considered in the differential diagnoses of a warm and swollen single joint, especially in the presence of risk factors, until it is excluded. Knowledge of regional epidemiological data is essential in planning treatment approaches.

Keywords

• risk factors
• septic arthritis
• Staphylococcus aureus
• treatment

Akut Septik Artritli Hastaların Yönetimi: Epidemiyolojik Bir Çalışma

Abstract

Amaç: Bu çalışmada akut bakteriyel septik artrit vakalarında etken, tanı ve tedavi sonuçlarını irdelenmesi amaçlandı. Gereç ve Yöntemler: Bu retrospektif, tek merkezli yürütülen çalışmada, Ocak 2015 ile Nisan 2021 tarihleri arasında, akut septik artrit tanısı ile izlenen 18 yaş ve üzerindeki hastalar, hastane veri tabanından taranarak belirlendi. Bu hastaların demografik özellikleri, tanı konulma prosedürleri, tedavi yönetimi ve sonuçları dosyalara kaydedildi. Bulgular: Çalışmaya toplam 59 hasta, 60 eklem septik artriti dahil edildi. Olguların %52,54’ünde etken mikroorganizma izole edildi. Vakaların %70,96’sında Staphylococcus aureus üredi ve bunların %31,82’i methisilline dirençli idi. En fazla tutulan eklem, diz eklemi olarak saptandı (%73,33). Olguların %42,37’sinde ateş yüksekliği tespit edildi. Komorbiditeler arasında en sık diyabet yer almakta olup (%30,51), olguların %39'unda immun supresyona yol açacak bir neden saptandı. Septik artrit tedavi yönetiminde en sık kullanılan cerrahi yöntem artrotomi idi (%43,55). Tedavi sonuçları değerlendirildiğinde ölüm oranı %6,78 olarak tespit edildi. Olgular kültürde mikroorganizma izole edilen ve edilmeyen grup olarak kategorize edildi. Bu iki grup karşılaştırıldığında hastanede yatış süreleri dışında istatistiksel olarak anlamlı bir fark saptanmadı (p=0,001). Sonuç: Sadece bir eklemde ısı artışı ve şişlik olması durumunda, özellikle risk faktörleri varlığında, ayırıcı tanıda aksi kanıtlanana kadar septik artrit tanısı öncelikle yer almalıdır. Tedavi yaklaşımlarının planlanmasında, bölgesel epidemiyolojik verilerin bilgisi esastır.

Keywords

• risk faktörleri
• septik artrit
• Staphylococcus aureus
• tedavi

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