Rates of, and risk factors for, septic arthritis in patients with invasive pneumococcal disease: prospective cohort study

Thomas J Marrie,Gregory J Tyrrell,Sumit R Majumdar,Dean T Eurich

doi:10.1186/s12879-017-2797-7

Abstract

BackgroundThere are many case reports of septic arthritis complicating invasive pneumococcal disease (IPD); however, no study has compared patients with IPD with septic arthritis to those who didn’t develop septic arthritis Thus, we aimed to determine the rates of, and risk factors for, septic arthritis in patients with invasive pneumococcal disease (IPD).MethodsSocio-demographic, clinical, and serological data were captured on all patients with IPD in Northern Alberta, Canada from 2000 to 2014. Septic arthritis was identified by attending physicians. Descriptive statistics and multivariate analyses were used to compare characteristics of those with septic arthritis and IPD to those who did not.ResultsSeptic arthritis developed in 51 of 3251 (1.6%) of patients with IPD. Inability to walk independently, male sex, and underlying joint disease were risk factors for developing septic arthritis in patients with IPD. Capsular serotypes 22 and 12F were more common in patients with septic arthritis than those without.ConclusionsIn patients with IPD, septic arthritis is uncommon. Certain risk factors such as walking with or without assistance and underlying joint disease make biological sense as damaged joints are more likely to be infected in the presence of bacteremia.Trial registrationNot applicable.

Highlights

There are many case reports of septic arthritis complicating invasive pneumococcal disease (IPD); no study has compared patients with IPD with septic arthritis to those who didn’t develop septic arthritis we aimed to determine the rates of, and risk factors for, septic arthritis in patients with invasive pneumococcal disease (IPD)
The patients with septic arthritis were less likley to walk independently and less likely to have chronic obstructive pulmonary disease (Table 1). 27.4% of the septic arthritis patients had underlying joint disease compared with 8.5% in the non-septic arthritis group (Table 1)
No other characteristics were associated with septic arthritis (p > 0.1)

Summary

Introduction

There are many case reports of septic arthritis complicating invasive pneumococcal disease (IPD); no study has compared patients with IPD with septic arthritis to those who didn’t develop septic arthritis we aimed to determine the rates of, and risk factors for, septic arthritis in patients with invasive pneumococcal disease (IPD). While the clinical features of this entity have been adequately described there has been no study that has compared patients with invasive pneumococcal disease (IPD) with septic arthritis to those who didn’t develop septic arthritis. Such a comparison would allow a delineation of the risk factors for septic arthritis.

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