Please use this identifier to cite or link to this item: http://localhost:8080/xmlui/handle/123456789/12214
Title: Predictors of bloodstream infection and its impact on mortality in septic arthritis: A 15-year review
Authors: Lee, Yongseop
Kim, Yong Chan
Seong, Jaeeun
Ahn, Sangmin
Han, Min
Lee, Jung Ah
Kim, Jung Ho
Keywords: Septic arthritis
Bloodstream infection
Lymphopenia
Sequential organ failure assessment score
Staphylococcus aureus
Issue Date: Feb-2025
Publisher: Elsevier Taiwan LLC
Abstract: Background: Septic arthritis is frequently complicated by bloodstream infection (BSI), which can lead to metastatic infections and sepsis. In the current study, we aimed to identify risk factors for septic arthritis-related BSI and assess its impact on clinical outcomes. Methods: A retrospective review spanning 15 years (January 2009 to May 2023) was conducted on patients diagnosed with septic arthritis. Data from patients with positive synovial fluid cultures were analyzed. Results: Among 456 patients with septic arthritis, 16.8 % (n = 77) developed BSI. The 90-day mortality rate was significantly higher in patients with BSI than in those without BSI (14.3 % vs. 5.3 %, p = 0.004). Staphylococcus aureus was the most commonly identified organism in synovial fluid cultures, and the presence of S. aureus infection was associated with an increased risk of BSI (adjusted odds ratio [aOR], 2.20; 95 % confidence interval [CI], 1.15–4.34; p = 0.019). Independent risk factors for BSI included a higher Sequential Organ Failure Assessment (SOFA) score (aOR, 1.23; 95 % CI, 1.06–1.44; p = 0.009), lymphopenia (aOR, 2.84; 95 % CI, 1.38–6.15; p = 0.006), and elevated C-reactive protein (mg/dL) levels (aOR, 1.07; 95 % CI, 1.05–1.10; p < 0.001). Age ≥70 years (aOR, 3.96; 95 % CI, 1.49–11.85; p = 0.009) and a higher SOFA score (aOR, 1.36; 95 % CI, 1.12–1.67; p = 0.002) were significant predictors of 90-day mortality, although BSI itself was not. Conclusion: Mortality in patients with septic arthritis was primarily associated with systemic sepsis due to BSI rather than BSI itself. Understanding the relationship between septic arthritis-related BSI and clinical outcomes could aid physicians in managing systemic infections and improving patient care.
URI: http://localhost:8080/xmlui/handle/123456789/12214
Appears in Collections:Vol 58 No 3 (2025)

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