A 10 Year clinical, laboratory and arthroscopic data analysis of bacterial septic arthritis of adult native knee: A hospital-based study

Abstract

ObjectiveA hospital-based study was conducted to analyze the clinical, laboratory and arthroscopic data of bacterial septic arthritis of the native knee in adults treated over ten years. MethodBetween 2010 and 2019, the clinical, laboratory and arthroscopic data of all adult patients who underwent Arthroscopic debridement for diagnosed or suspected septic arthritis of the knee were reviewed from the medical records. Statistical analysis was performed to compare these characteristics between positive and negative cultures and between patients with or without co-morbidities. Further, these characteristics were also compared between patients who had Staphylococcus aureus infection versus non-Staphylococcal infection. ResultsThe data from 106 cases comprising of 86 males and 20 females were analyzed. The mean age of the study population was 51.04±15.38 years. Positive cultures were observed in only 38 cases (35.84%). Between positive and negative cultures, statistically significant differences were found for haemoglobin levels, CRP, total protein in the synovial fluid, duration of antibiotic course and length of hospital stay. Between patients with or without co-morbidities, statistically, significant differences were found for patients ‘age, haemoglobin levels, RBS, HbA1c, Serum Urea, Creatinine, ESR, CRP, the total duration of antibiotic course and length of hospital stay. No major differences were observed between patients with Staphylococcus aureus related and non-Staphylococcus aureus related infections. ConclusionIn most of the cases no organisms were isolated from the synovial fluid or the tissues. Among the positive cultures, Staphylococcus aureus was the most common organism isolated, with nearly half of them (42.8%) being MRSA. Patients with positive cultures and associated medical co-morbidities were treated with a longer duration of the antibiotic course and had a longer hospital stay. Awareness among the clinicians and microbiologists about the new emerging infections in the native knee is vitally important.