Prevalence and Antibiotic Susceptibility of Common Bacterial Agents Causing Septic Arthritis in Shiraz, Southwestern Iran

Abstract

Background: Septic arthritis (SA) or infectious arthritis (IA) typically occurs following hematogenous inoculation of pathogenic organisms in susceptible individuals. This infection is commonly a result of hematogenous spread of the infectious agent, inflammation or bone infection dissemination, as well as trauma or surgery. Early diagnosis and treatment of SA are crucial for affected patients. Objectives: This retrospective study aimed to investigate the prevalence of bacterial SA and the trend of antibiotic resistance in a specialized orthopedic and neurosurgery hospital from 2018 to 2020. Methods: Patient records from the hospital admissions between 2018 and 2020 were reviewed. Data including patient age, gender, hospital ward, and antibiotic susceptibility test results were extracted and recorded for analysis. Statistical analysis was performed using SPSS version 22 software. Results: Among the 249 cases investigated, 29 positive bacterial cultures were reported (11.6%). The knee joint was the most commonly affected (48.3%), followed by the ankle (27.6%). The most frequently prescribed antibiotics were ciprofloxacin, cefazolin, and cephalexin, respectively. Over the three-year study period, an increase in antibiotic resistance to ciprofloxacin and cefazolin and a decrease in antibiotic resistance to cephalexin were observed. Conclusions: Despite its common occurrence, diagnosing SA can be challenging. Early joint surgery (arthrotomy) along with the initiation of effective antibiotic therapy plays a crucial role in reducing the incidence of complications associated with this disease.