Risk Factors, Screening, and Treatment Challenges in Native Septic Arthritis.

Open Forum Infect Dis

Division of Infectious Disease, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

Published: January 2021

AI Article Synopsis

  • A retrospective study analyzed 215 cases of native septic arthritis from 2012-2016, emphasizing the impact of the opioid epidemic on patient demographics and risk factors.
  • The findings indicated that factors like injection drug use increased the odds of infection, while older age and higher comorbidity scores were associated with lower odds.
  • MRSA screening in patients showed a sensitivity of 59% and a high specificity of 96%, suggesting it may be effective in identifying MRSA infections within this population.

Article Abstract

Background: is the most common cause of native septic arthritis. Few studies have characterized this disease during the US opioid epidemic. The role of methicillin-resistant (MRSA) nasal screening in this disease has not been elucidated. We sought to identify risk factors and outcomes for native septic arthritis and to evaluate MRSA screening in this disease.

Methods: A retrospective cohort study of native septic arthritis patients (2012-2016) was performed. Demographics, risk factors, and outcomes were compared between and other native septic arthritis infections. Sensitivity, specificity, and predictive values of MRSA screening were assessed.

Results: Two hundred fifteen cases of native septic arthritis were included. s was cultured in 64% (138/215). MRSA was cultured in 23% (50/215). was associated with injection drug use (odds ratio [OR], 4.33; 95% CI, 1.74-10.81; = .002) and switching antibiotics (OR, 3.92; 95% CI, 1.01-21.38; = .032). For every 10-year increase in age, the odds of decreased (OR, 0.72; 95% CI, 0.60-0.87; = .001). For 1-unit increases in Charlson comorbidity index score, the odds of decreased (OR, 0.82; 95% CI, 0.73-0.91; = .0004). MRSA screening during admission demonstrated a sensitivity of 0.59, specificity of 0.96, positive predictive value of 0.85, and negative predictive value of 0.84 for MRSA native septic arthritis.

Conclusions: The opioid epidemic may be contributing to a demographic shift in native septic arthritis to younger, healthier individuals. native septic arthritis has unique risks, including injection drug use. MRSA screening may be useful to rule in MRSA native septic arthritis.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813160PMC
http://dx.doi.org/10.1093/ofid/ofaa593DOI Listing

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