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Clinical Characteristics and Causative Pathogens of Infective Arthritis and Risk Factors for Gram-Negative Bacterial Infections

Infection & Chemotherapy 2020년 52권 4호 p.503 ~ 515
이용섭, 조윤석, 손유진, 현종훈, 안상민, 이운지, 김정호, 성혜, 김준형, 정수진, 구남수, 염준섭, 안진영, 최준용,
소속 상세정보
이용섭 ( Lee Yong-Seop ) - Yonsei University College of Medicine Department of Internal Medicine
조윤석 ( Cho Yun-Suk ) - Yonsei University College of Medicine Department of Internal Medicine
손유진 ( Sohn Yu-Jin ) - Yonsei University College of Medicine Department of Internal Medicine
현종훈 ( Hyun Jong-Hoon ) - Yonsei University College of Medicine Department of Internal Medicine
안상민 ( Ahn Sang-Min ) - Yonsei University College of Medicine Department of Internal Medicine
이운지 ( Lee Woon-Ji ) - Yonsei University College of Medicine Department of Internal Medicine
김정호 ( Kim Jung-Ho ) - Yonsei University College of Medicine Department of Internal Medicine
성혜 ( Seong Hye ) - Yonsei University College of Medicine Department of Internal Medicine
김준형 ( Kim Jun-Hyoung ) - Yonsei University College of Medicine Department of Internal Medicine
정수진 ( Jeong Su-Jin ) - Yonsei University College of Medicine Department of Internal Medicine
구남수 ( Ku Nam-Su ) - Yonsei University College of Medicine Department of Internal Medicine
염준섭 ( Yeom Joon-Sup ) - Yonsei University College of Medicine Department of Internal Medicine
안진영 ( Ahn Jin-Young ) - Yonsei University College of Medicine Department of Internal Medicine
최준용 ( Choi Jun-Yong ) - Yonsei University College of Medicine Department of Internal Medicine

Abstract


Background: The aim of this study was to describe the clinical and microbiological characteristics of infective arthritis and to analyze risk factors for Gram-negative bacterial infections that cause infective arthritis.

Materials and Methods: Patients admitted between 2009 - 2018 with infective arthritis in a single-tertiary hospital were evaluated retrospectively.

Results: A total of 181 patients were enrolled in this study. Of them, 135 were native joint infection patients and 46 were prosthetic joint infection patients. The most common site of infective arthritis was the knee (63.6%), followed by the shoulder (17.7%), and the hip (9.9%). The most frequently identified microorganisms were Staphylococcus aureus (51.1%), followed by Streptococci sp. (21.1%), Enterobacteriaceae (8.4%), and coagulase-negative-Staphylococci (CNS; 8.4%). Infections due to Gram-negative bacteria and fungi made up 13.7% and 3.2% of all cases, respectively. Additionally, 20% and 4.2% of the cases involved methicillin-resistant S. aureus (MRSA) and MRCNS. We found that bacteriuria, infective arthritis in the hip, and steroid use at admission are independent risk factors for Gram-negative bacterial infections.

Conclusion: Infective arthritis with methicillin-resistant microorganisms reached up to about 25% in a single-tertiary hospital in Korea. In case of suspected urinary tract infection, infective arthritis of the hip joint, or steroid use at admission time among infective arthritis patients, empirical treatment covering Gram-negative microorganisms can be considered.

키워드

Arthritis, infectious; Gram-negative bacterial infections; Methicillin resistance; Risk factors

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