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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) |
Files in This Item:
File | Description | Size | Format | |
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Predictors-of-bloodstream-infection-and-its-impa_2025_Journal-of-Microbiolog.pdf | 1.6 MB | Adobe PDF | View/Open |
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