A ten-year retrospective analysis of risk factors and comorbidities prevalence in a group of septic arthritis patients.

Objectives: The aim of this study was the evaluation of a group of patients treated at the Department of Orthopaedics and Traumatology of Locomotory Apparatus at Luis Pasteur University Hospital in Košice for septic arthritis in relation to risk factors and chronic diseases and its microbial aetiologic profile.

Methods: We conducted a retrospective study of patients including all episodes of septic arthritis from March 2013 to August 2022. The occurrence of chronic diseases, risk factors and its microbiological profile were investigated.

Results: A total of 141 patients were included: 92 (65%) males and 49 (35%) females, the mean age of patients was 58.1 years. A continued decrease in cases was recorded during the period of COVID-19 pandemic and the post-pandemic years. The largest group of our cohort represented septic arthritis of the knee (87 cases, 61.7%), followed by hip and shoulder arthritis - 17 (12.1%) and 14 (9.9%) cases, respectively. Gram positive aetiologic flora represented 87.5% of all pathogens isolated and antibiotics were administered to 46 (32.6%) patients before microbiological culture samples were obtained. The dominant chronic disease was diabetes mellitus with 42 (29.8%) cases and degenerative joint disease affecting the joint was verified in 86 (61%) patients. Dental foci in 28 (19.9%) cases and skin infections in 17 (12.1%) cases were the most numerous groups of risk factors with predominant distribution for cases without previous intervention in the affected joint leading to infection.

Conclusion: The distribution of joint involvement and microbial agents was similar to other literature without affecting negative culture results by prior administration of antibiotics. Representation of chronic diseases and risk factors was comparable to the work of other authors. Notable was the continued decline in total number of cases in post-pandemic years of COVID-19 pandemic. What was interesting was the number of confirmed cases of distant focal infection distributed mainly in the group of patients without a history of any previous intervention on the joint before the infection. There is a lack of literature on distant silent infection as a risk factor.