Repository logo
 
Publication

Adult Native Joint Septic Arthritis: A Nine-Year Retrospective Analysis in a Portuguese University Hospital

2021Journal article Open access
Simple item page
dc.contributor.authorCipriano, Ana
dc.contributor.authorVideira Santos, Fábio
dc.contributor.authorDias, Rita
dc.contributor.authorCarvalho, André
dc.contributor.authorReis, Ernestina
dc.contributor.authorPereira, Claudia
dc.contributor.authorSantos, Ana Cláudia
dc.contributor.authorSousa, Ricardo
dc.contributor.authorAbreu, Miguel
dc.date.accessioned2022-08-29T08:53:23Z
dc.date.available2022-08-29T08:53:23Z
dc.date.issued2021
dc.description.abstractntroduction: Septic arthritis of a native joint represents a medical emergency. Drainage and effective antibiotic treatment are critical to avoid joint destruction and long-term impairment. The aim of this study was to evaluate epidemiological and clinical characteristics of patients with the diagnosis of septic arthritis to help establish local guidelines for empirical antibiotic treatment. Material and methods: Retrospective analysis of adult patients admitted at Centro Hospitalar Universitário do Porto from 2009 to 2017 with suspected native joint septic arthritis. Relevant demographics, microbiology findings and respective antibiotic susceptibilities were analysed. Results: Ninety-seven patients, predominantly males (59.8%) with a median age of 61 years old were included. The most commonly reported comorbidity associated with septic arthritis was diabetes mellitus (20.6%). The knee was the most commonly affected joint (71.1%). Arthrocentesis was performed in all patients, but only 50.5% had positive microbial growth in the synovial fluid. Staphylococcus aureus was the most frequently identified microorganism, 86% of which were methicillin susceptible. Gram-negative bacteria were the causative agent in 15% of cases. A wide range of empirical antibiotic regimens were prescribed with a combination of vancomycin/carbapenem being the most common (30.9%). Analysis of antibiotic susceptibility profiles revealed that amoxicillin/clavulanate would have been appropriate as the initial regimen in 89% of cases. Discussion: The main causative pathogen was Staphylococcus aureus, with methicillin resistant Staphylococcus aureus remaining rare. The proportion of Gram-negative bacteria implies that these agents should be covered by empirical treatment, although no case of Pseudomonas infection has been identified. Therefore, antipseudomonal coverage is not necessary in empirical regimens. Conclusion: Routine coverage of methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa is not warranted but must be considered when specific risk factors are found. Amoxicillin/clavulanate can provide adequate antibiotic coverage as an empirical treatment for adult native joint septic arthritis. Its use may allow a reduction in use of broader spectrum antibiotics.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationCipriano A, Santos FV, Dias R, et al. Adult Native Joint Septic Arthritis: A Nine-Year Retrospective Analysis in a Portuguese University Hospital. Acta Med Port. 2021;34(12):826-832. doi:10.20344/amp.12998pt_PT
dc.identifier.doi10.20344/amp.12998pt_PT
dc.identifier.issn0870-399X
dc.identifier.issn1646
dc.identifier.urihttp://hdl.handle.net/10400.16/2733
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherCentro Editor Livreiro da Ordem dos Médicospt_PT
dc.relation.publisherversionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/12998pt_PT
dc.subjectAnti-Infective Agentspt_PT
dc.subjectAntimicrobial Stewardshippt_PT
dc.subjectArthritis, Infectiouspt_PT
dc.subjectJointspt_PT
dc.titleAdult Native Joint Septic Arthritis: A Nine-Year Retrospective Analysis in a Portuguese University Hospitalpt_PT
dc.title.alternativeArtrite Séptica de Articulação Nativa em Adultos: Estudo Retrospetivo de Nove Anos num Hospital Universitário Portuguêspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.conferencePlacePortugalpt_PT
oaire.citation.endPage832pt_PT
oaire.citation.issue12pt_PT
oaire.citation.startPage826pt_PT
oaire.citation.titleActa Médica Portuguesapt_PT
oaire.citation.volume34pt_PT
person.familyNameCipriano
person.familyNameVideira Santos
person.familyNameSousa
person.familyNameVieira Braga de Araújo Abreu
person.givenNameAna
person.givenNameFábio
person.givenNameRicardo
person.givenNameMiguel
person.identifier.ciencia-id8C18-816F-6E4A
person.identifier.ciencia-id5812-146E-1715
person.identifier.orcid0000-0003-1551-6897
person.identifier.orcid0000-0002-9098-3412
person.identifier.orcid0000-0003-4293-7347
person.identifier.orcid0000-0001-6999-6641
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationcc67fc2b-f0dd-480c-8b0f-e41b54efaceb
relation.isAuthorOfPublication9798f562-cd1e-440a-b568-45c49583fa55
relation.isAuthorOfPublication2f21d3c0-c752-499f-9bcc-d87d9fd31d5c
relation.isAuthorOfPublication0c2a26b0-8a1e-4c20-8e97-09abcce39e3d
relation.isAuthorOfPublication.latestForDiscoverycc67fc2b-f0dd-480c-8b0f-e41b54efaceb

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Cipriano-2021-Adult-native-joint-septic-arthritis.pdf
Size:
433.9 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.35 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

SINF - Artigos publicados em revistas indexadas na Pubmed/Medline
MED 1A - Artigos publicados em revistas indexadas na Pubmed/Medline
SM - Artigos publicados em revistas indexadas na Pubmed/Medline
SO - Artigos publicados em revistas indexadas na Pubmed/Medline