Evaluation of distribution and susceptibility of microorganisms isolated from joint fluid cultures: five-year data

Yıl 2023, Cilt: 5 Sayı: 4, 432 - 437, 27.10.2023

Halil Er Özlem Koca Nevgün Sepin Özen

https://doi.org/10.38053/acmj.1342396

Öz

Aims: Septic arthritis is joint inflammation. It is an orthopedic emergency that requires prompt diagnosis and treatment. In this study, it was aimed to examine the distribution and antibiotic resistance profiles of microorganisms isolated from joint fluid samples taken from patients who applied to the orthopedic clinic of our hospital in the last five years.
Methods: In our study, 1162 joint fluid samples were sent to the medical microbiology laboratory of our hospital from the orthopedics and traumatology clinic between January 01, 2018 and December 31, 2022. Joint fluid samples taken from clinically appropriate patients under sterile conditions were incubated in a BacT/Alert 3D (Biomerieux, France) culture device. Bacteria isolated from 164 specimens with growth detected, were identified by matrix-mediated laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) based VITEK MS (Biomerieux, France). Antibiotic susceptibility tests were performed on the VITEK 2 Compact (Biomerieux, France) device.
Results: Staphylococcus aureus (S. aureus) (29.3%) and coagulase negative Staphylococci (CNS) (29.3%) were the most commonly grown microorganisms. Other microorganisms grown were Streptococcus spp. (9.1%), Enterococcus spp. (6.1%), Pseudomonas aeruginosa (P. aeuruginosa) (7.3%), Escherichiae coli (E. coli) (4.3%) and Klebsiella pneumoniae (K. pneumoniae) (4.3%). When antibiotic susceptibility results were evaluated according to EUCAST restricted reporting criteria, linezolid in Gram-positive strains, amikacin in Enterobacterales, colistin and tigecycline in nonfermentative Gram-negative bacteria were found to be the most susceptible antibiotics.
Conclusion: The continuous change in antibiotic susceptibility profiles in joint infections, the long duration of treatment and follow-up, and the increase in polymicrobial infections require regular monitoring of culture and antibiotic susceptibility tests. In our study, the distribution of microorganisms isolated from joint fluid samples of our hospital and the determination of antibiotic resistance profiles will contribute to the clinician in terms of guiding empirical treatment.

Anahtar Kelimeler

Joint fluid, antibiotic resistance rates, septic arthritis, Staphylococcus aureus

Kaynakça

• García-Arias M, Balsa A, Mola EM. Septic arthritis. Best Pract Res Clin Rheumatol. 2011;25(3):407-421.
• Balato G, Matteo V, Ascione T. et al. Management of septic arthritis of the hip joint in adults. A systematic review of the literature. BMC Musculoskelet Disord. 2021;22(2):1006.
• Combs K, Cox K. Clinical outcomes involving patients that develop septic arthritis with methicillin sensitive Staphylococcus aureus versus methicillin resistant Staphylococcus aureus. J. Orthop. 2018;15(1):9-12.
• Mathews CJ, Weston VC, Jones A, Field M, Coakley G. Bacterial septic arthritis in adults. Lancet. 2010;375(9717):846-855.
• Wang J, Wang L. Novel therapeutic interventions towards improved management of septic arthritis. BMC Musculoskelet Disord. 2021;22(1)530:1-18.
• Long B, Koyfman A, Gottlieb M. Evaluation and management of septic arthritis and its mimics in the emergency department. West. J Emerg Med. 2019; 20(2):331-341.
• Yapar A, Şenol MS, Özer H, Selek HY. Proteze bağlı eklem enfeksiyonları. Atik OŞ, editör. Eklem Hastalıkları Tedavisinde Güncel Yaklaşımlar. 1. Baskı. Ankara: Türkiye Klinikleri. 2019:29-36.
• Flores-Robles BJ, Palop MJ, Sanchinel AAS, et al. Medical versus surgical approach to initial treatment in septic arthritis: a single Spanish center’s 8-year experience. J Clin Rheumatol. 2019;25(1):4-8.
• El-Ganzoury I, Eid AS. Two-stage arthroplasty using functional temporary prosthesis to treat infected arthroplasty and septic arthritis of the hip. J Orthop. 2015;12(1):86-93.
• Bauer T, Lacoste S, Lhotellier L, Mamoudy P, Lortat-Jacob A, Hardy P. Arthroplasty following a septic arthritis history: a 53 cases series. Orthop Traumatol Surg Res. 2010;96(8):840-843.
• Hasbek M, Çubuk F. Evaluation of distribution of microorganisms isolated from joint fluid cultures and antimicrobial susceptibility of staphylococci isolated from these cultures. Klimik J. 2022;35(2):90-94.
• Chen CE, Wang JW, Juhn RJ. Total hip arthroplasty for primary septic arthritis of the hip in adults. Int Orthop. 2008;32(5):573-580.
• Savcı Ü, Alıç T, Güreser AS, Özkan AT. Wound infections after orthopedic surgery: distribution and resistance situations of microorganisms. Ortadoğu Tıp Derg. 2018;10(4):492-497.
• Kurutepe S, Sürücüoğlu S, Gazi H, et al. Metisiline-dirençli ve duyarlı Staphylococcus aureus suşlarının antibiyotiklere direnç oranları. İnfeksiyon Derg./Turkish J Infect. 2007;21(4):187-191.
• Özel Y, Büyükzengin KB, Yavuz MT. Investigation of antibiotic resistance profile of methicillin resistant and susceptible Staphylococcus aureus strains isolated from clinical samples. Ankem Derg. 2017;31(2):41-47.
• Sen P. Demirdal T, Özdemir R, et al. Antimicrobial resistance in staphylococci: a 6-year-evaluation. Medeniyet Med J. 2017; 32(4):205-211.
• Ross JJ, Ard KL, Carlile N. Septic arthritis and the opioid epidemic: 1465 cases of culture-positive native joint septic arthritis from 1990-2018. Open Forum Infect Dis. 2020;7(3):1-7.
• Arunshankar A, Chandy VJ, Elangovan D, et al. Microbiological profile of infections of the hip joint: an Indian perspective. Indian J Med Microbiol. 2019;37(4):509-513.