1921
Volume 97, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Septic arthritis is a medical emergency, and if not treated appropriately, it can be associated with high morbidity and mortality. Melioidosis, a serious infectious disease caused by the Gram-negative bacillus , is highly endemic in South and Southeast Asia and northern Australia. We reviewed the medical charts of adult patients admitted with bacterial septic arthritis at Sunpasitthiprasong Hospital, Ubon Ratchathani, northeast Thailand from January 2012 to December 2014. Bacterial septic arthritis was defined as one or more hot swollen joints with isolation of a pathogenic organism from an affected joint or from blood. A total of 154 patients with septic arthritis were retrospectively evaluated. The most common causes were (48%, = 74), spp. (29%, = 44), and (10%, = 16). Prevalence of diabetes, bacteremia, and pneumonia was higher in septic arthritis than in septic arthritis caused by the other bacteria (all < 0.01). Seventy three percent (54/74) of patients infected with and 69% (55/80) of patients with the other bacteria received effective antimicrobials on the first day of admission ( = 0.60), but in-hospital mortality of the former group was considerably higher (34% versus 14%, = 0.004). In conclusion, septic arthritis is common and associated with high mortality in northeast Thailand. Emergence of arthritis is observed. Difficulty in diagnosing melioidosis and identifying in areas where health care workers are not familiar with the disease is discussed. In melioidosis-endemic regions, parenteral ceftazidime could be considered as empirical antimicrobial therapy for patients with septic arthritis and underlying diseases.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.17-0288
2017-12-06
2017-12-15
Loading full text...

Full text loading...

/deliver/fulltext/14761645/97/6/tpmd170288.html?itemId=/content/journals/10.4269/ajtmh.17-0288&mimeType=html&fmt=ahah

References

  1. Mathews CJ, Weston VC, Jones A, Field M, Coakley G, , 2010. Bacterial septic arthritis in adults. Lancet 375: 846855.[Crossref]
  2. Goldenberg DL, , 1998. Septic arthritis. Lancet 351: 197202.[Crossref]
  3. Morgan DS, Fisher D, Merianos A, Currie BJ, , 1996. An 18 year clinical review of septic arthritis from tropical Australia. Epidemiol Infect 117: 423428.[Crossref]
  4. Saraux A, 1997. HIV infection as a risk factor for septic arthritis. Br J Rheumatol 36: 333337.[Crossref]
  5. Thomas J, Jayachandran NV, Shenoy Chandrasekhara PK, Lakshmi V, Narsimulu G, , 2008. Melioidosis—an unusual cause of septic arthritis. Clin Rheumatol 27 (Suppl 2): S59S61.[Crossref]
  6. Caldera AS, Kumanan T, Corea E, , 2013. A rare cause of septic arthritis: melioidosis. Trop Doct 43: 164166.[Crossref]
  7. Lipsitz R, 2012. Workshop on treatment of and postexposure prophylaxis for Burkholderia pseudomallei and B. mallei infection, 2010. Emerg Infect Dis 18: e2.[Crossref]
  8. Currie BJ, Ward L, Cheng AC, , 2010. The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study. PLoS Negl Trop Dis 4: e900.[Crossref]
  9. Limmathurotsakul D, Wongratanacheewin S, Teerawattanasook N, Wongsuvan G, Chaisuksant S, Chetchotisakd P, Chaowagul W, Day NP, Peacock SJ, , 2010. Increasing incidence of human melioidosis in northeast Thailand. Am J Trop Med Hyg 82: 11131117.[Crossref]
  10. Limmathurosakul D, 2016. Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis. Nat Microbiol 1: 15008.[Crossref]
  11. Currie BJ, Jacups SP, Cheng AC, Fisher DA, Anstey NM, Huffam SE, Krause VL, , 2004. Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia. Trop Med Int Health 9: 11671174.[Crossref]
  12. Shirtliff ME, Mader JT, , 2002. Acute septic arthritis. Clin Microbiol Rev 15: 527544.[Crossref]
  13. Louthrenoo W, Kasitanon N, Wangkaew S, Hongsongkiat S, Sukitawut W, Wichainun R, , 2014. Streptococcus agalactiae: an emerging cause of septic arthritis. J Clin Rheumatol 20: 7478.[Crossref]
  14. Takeuchi D, 2012. Population-based study of Streptococcus suis infection in humans in Phayao Province in northern Thailand. PLoS One 7: e31265.[Crossref]
  15. Bell JM, Turnidge JD, Cefepime Study Group, , 2001. Multicentre study of the in vitro activity of cefepime, a broad-spectrum cephalosporin, compared to other broad-spectrum agents. Pathology 33: 5360.[Crossref]
  16. Nickerson EK, 2009. Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance. PLoS One 4: e4308.[Crossref]
  17. Kanoksil M, Jatapai A, Peacock SJ, Limmathurotsakul D, , 2013. Epidemiology, microbiology and mortality associated with community-acquired bacteremia in northeast Thailand: a multicenter surveillance study. PLoS One 8: e54714.[Crossref]
  18. Teparrakkul P, Tsai JJ, Chierakul W, Gerstenmaier JF, Wacharaprechasgu T, Piyaphanee W, Limmathurotsakul D, Chaowagul W, Day NP, Peacock SJ, , 2008. Rheumatological manifestations in patients with melioidosis. Southeast Asian J Trop Med Public Health 39: 649655.
  19. Morris JL, Fane A, Sarovich DS, Price EP, Rush CM, Govan BL, Parker E, Mayo M, Currie BJ, Ketheesan N, , 2017. Increased neurotropic threat from Burkholderia pseudomallei strains with a B. mallei-like variation in the bimA motility gene, Australia. Emerg Infect Dis 23: 740749.[Crossref]
  20. Sarovich DS, Price EP, Webb JR, Ward LM, Voutsinos MY, Tuanyok A, Mayo M, Kaestli M, Currie BJ, , 2014. Variable virulence factors in Burkholderia pseudomallei (melioidosis) associated with human disease. PLoS One 9: e91682.[Crossref]
  21. Pandey V, Rao SP, Rao S, Acharya KK, Chhabra SS, , 2010. Burkholderia pseudomallei musculoskeletal infections (melioidosis) in India. Indian J Orthop 44: 216220.[Crossref]
  22. Wiersinga WJ, Currie BJ, Peacock SJ, , 2012. Melioidosis. N Engl J Med 367: 10351044.[Crossref]
  23. Kaandorp CJ, Dinant HJ, van de Laar MA, Moens HJ, Prins AP, Dijkmans BA, , 1997. Incidence and sources of native and prosthetic joint infection: a community based prospective survey. Ann Rheum Dis 56: 470475.[Crossref]
  24. Suputtamongkol Y, 1999. Risk factors for melioidosis and bacteremic melioidosis. Clin Infect Dis 29: 408413.[Crossref]
  25. Lin WT, Tang HJ, Lai CC, Chao CM, , 2017. Clinical manifestations and bacteriological features of culture-proven Gram-negative bacterial arthritis. J Microbiol Immunol Infect 50: 527531.[Crossref]
  26. Ferrand J, El Samad Y, Brunschweiler B, Grados F, Dehamchia-Rehailia N, Sejourne A, Schmit JL, Gabrion A, Fardellone P, Paccou J, , 2016. Morbimortality in adult patients with septic arthritis: a three-year hospital-based study. BMC Infect Dis 16: 239.[Crossref]
  27. Wooten MD, Panwalker AP, , 2001. Septic arthritis caused by Burkholderia pseudomallei: case report and review of the literature. J Clin Rheumatol 7: 242247.[Crossref]
  28. Hoffmaster AR, 2015. Melioidosis diagnostic workshop, 2013. Emerg Infect Dis 21: 19.[Crossref]
  29. Dance DA, Limmathurotsakul D, Currie BJ, , 2017. Burkholderia pseudomallei: challenges for the clinical microbiology laboratory-a response from the front line. J Clin Microbiol 55: 980982.[Crossref]
  30. Cheng AC, Currie BJ, , 2005. Melioidosis: epidemiology, pathophysiology, and management. Clin Microbiol Rev 18: 383416.[Crossref]
  31. Morse LP, Smith J, Mehta J, Ward L, Cheng AC, Currie BJ, , 2013. Osteomyelitis and septic arthritis from infection with Burkholderia pseudomallei: a 20-year prospective melioidosis study from northern Australia. J Orthop 10: 8691.[Crossref]
  32. Kosuwon W, Taimglang T, Sirichativapee W, Jeeravipoolvarn P, , 2003. Melioidotic septic arthritis and its risk factors. J Bone Joint Surg Am 85-A: 10581061.[Crossref]
  33. Pitman MC, Luck T, Marshall CS, Anstey NM, Ward L, Currie BJ, , 2015. Intravenous therapy duration and outcomes in melioidosis: a new treatment paradigm. PLoS Negl Trop Dis 9: e0003586.[Crossref]
  34. Goldenberg DL, Reed JI, , 1985. Bacterial arthritis. N Engl J Med 312: 764771.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.17-0288
Loading
/content/journals/10.4269/ajtmh.17-0288
Loading

Data & Media loading...

  • Received : 08 Apr 2017
  • Accepted : 08 Aug 2017

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error