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.

Department of Orthopaedics and Traumatology of Locomotory Apparatus Faculty of Medicine Pavol Jozef Safarik University and Louis Pasteur University Hospital in Kosice Kosice Slovak Republic

Department of Public Health and Hygiene Faculty of Medicine Pavol Jozef Safarik University in Kosice Kosice Slovak Republic

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Momodu II, Savaliya V. Septic arthritis. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; 2024 [cited 2024 Aug 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538176/.

Smith JW, Chalupa P, Shabaz Hasan M. Infectious arthritis: clinical features, laboratory findings and treatment. Clin Microbiol Infect. 2006;12(4):309-14. DOI

Oh BH, Heo YM, Yeo IU, Shin WJ, Yoo HJ. Efficacy of lavage by tube under local anesthesia versus arthroscopic treatment of acute septic arthritis of native knee. Diagnostics (Basel). 2023;13(3):371. doi: 10.3390/diagnostics13030371. PubMed DOI

Musil D, Chrdle A, Hornikova M, Balejova M, Klouda J, Pertlicek J, et al. [Native joint septic arthritis in adults: incidence in our group of patients and antibiotic therapy guidelines]. Acta Chir Orthop Traumatol Cech. 2021;88(5):354-61. Czech. DOI

Munoz-Gallego I, Mancheno M, Perez-Montarelo D, Viedma E, Chaves F, Lora-Tamayo J. Staphylococcus aureus native arthritis over 10 years. Med Mal Infect. 2020;50(3):257-62. DOI

Nissim L, Lieber SB, Naffaa ME, Fowler ML, Shmerling RH, Paz Z. The impact of gender on the clinical presentation, management, and surgical outcomes of patients with native-joint septic arthritis. J Eval Clin Pract. 2021;27(2):371-6. DOI

Duarte-Monteiro AM, Dourado E, Fonseca JE, Saraiva F. Safety of intra-articular glucocorticoid injections - state of the art. ARP Rheumatol. 2023;2(1):64-73.

Wong JSH, Cheung KMC. Impact of COVID-19 on orthopaedic and trauma service: an epidemiological study. J Bone Joint Surg Am. 2020;102(14):e80. doi: 10.2106/JBJS.20.00775. PubMed DOI

Malipeddi R, Nema SK, Gopisankar B, Prabu M, Pasupathy P, Suresh Gandhi B. Clinical outcomes and global health after joint debridement in adult-onset septic arthritis: a prospective observational study. Indian J Orthop. 2021;55(4):912-7. DOI

Nossent J, Raymond W, Keen H, Preen DB, Inderjeeth CA. Non-gonococcal septic arthritis of native joints in Western Australia. A longitudinal population-based study of frequency, risk factors and outcome. Int J Rheum Dis. 2021;24(11):1386-93. DOI

van der Merwe M, Rooks K, Crawford H, Frampton CMA, Boyle MJ. The effect of antibiotic timing on culture yield in paediatric osteoarticular infection. J Child Orthop. 2019;13(1):114-9. DOI

Li XR, Lucero M, Razzak AN, Jha P, Ugolini C. Complex case management of mycobacterium tuberculosis extrapulmonary manifestation to the right sacroiliac joint. Cureus. 2023;15(1):e33789. doi: 10.7759/cureus.33789. PubMed DOI

Gharib MH, Alebbi S, Rashid F, Elhaj MF, Zahirb FZ, Al Emadi S. Salmonella-related septic arthritis in an immunocompetent adult: a case report. Cureus. 2022;14(1):e21030. doi: 10.7759/cureus.21030. PubMed DOI

Konyves A, Deo SD, Murray JR, Mandalia VI, Von Arx OA, Troughton AH. Septic arthritis of the elbow after chickenpox. J Pediatr Orthop B. 2004;13(2):114-7. DOI

National Health Information Center. [Press release: NHIC: 349 595 patients with diabetes are monitored in Slovakia] [Internet]. Bratislava: NHIC; 2023 [cited 2024 Aug 25]. Available from: https://www.nczisk.sk/Documents/aktuality/tlacove_spravy/2023/TS_NCZI_Na_Slovensku_je_sledovanych_349595_pacientov_cukrovkou_14112023.pdf. Slovak.

Dolin E, Perlmutter LD, Segelnick SL, Weinberg MA, Schoor R. Septic arthritis of the shoulder in a dental patient: a case report and review. N Y State Dent J. 2014;80(3):18-20.

Fe Marques A, Maestre Vera JR, Mateo Maestre M, Gonzalez Romo F, Castrillo Amores MA. Septic arthritis of the knee due to Prevotella loescheii following tooth extraction. Med Oral Patol Oral Cir Bucal. 2008;13(8):E505-7.

Payne LZ, Wolfe SW. Septic arthritis in a normal interphalangeal joint following a dental procedure. J Hand Surg Am. 1994;19(5):815-6. DOI

Kikuchi T, Funaki M, Yamabe T, Oiwa H. A distant origin of sternoclavicular septic arthritis. Intern Med. 2016;55(5):551. doi: 10.2169/internalmedicine.55.5934. PubMed DOI

Weston V, Coakley G; British Society for Rheumatology (BSR) Standards, Guidelines and Audit Working Group; British Society for Antimicrobial Chemotherapy; British Orthopaedic Association; Royal College of General Practitioners, et al. Guideline for the management of the hot swollen joint in adults with a particular focus on septic arthritis. J Antimicrob Chemother. 2006;58(3):492-3. DOI

Radhamony NG, Walkay S, Palaneer S, Hamadto M. Predictors of failure after initial arthroscopic washout in septic arthritis of native knee joint- a retrospective analysis. Ann Med Surg (Lond). 2022;74:103269. doi: 10.1016/j.amsu.2022.103269. PubMed DOI