Chia Nan University of Pharmacy & Science Institutional Repository:Item 310902800/31706
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    標題: Clinical manifestations and bacteriological features of culture-proven Gram-negative bacterial arthritis
    作者: Lin, Wei-Ting
    Tang, Hung-Jen
    Lai, Chih-Cheng
    Chao, Chien-Ming
    貢獻者: Chi Mei Med Ctr, Dept Trauma
    Shu Zen Jr Coll Med & Management, Dept Phys Therapy
    Chi Mei Med Ctr, Dept Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Chi Mei Med Ctr, Dept Intens Care Med
    Min Hwei Coll Hlth Care Management, Dept Nursing
    關鍵字: antibiotic resistance
    Gram-negative bacteria
    outcome
    septic arthritis
    日期: 2017-08
    上傳時間: 2018-11-30 15:53:38 (UTC+8)
    出版者: Elsevier Taiwan
    摘要: Background/Purpose: To investigate the clinical manifestations and bacteriological features of culture-proven, Gram-negative bacterial arthritis. Methods: This study was conducted at theChi Mei Medical Center, a 1300-bed teaching hospital located in southern Taiwan. Patients with synovial fluid cultures positive for Gram-negative bacilli (GNB) during the period January 2009 to May 2014 were identified from the hospital's computerized microbiology database. Results: During the study period, a total of 48 patients with culture-confirmed, GNB septic arthritis were identified. In the majority of patients (n Z 33, 68.8%), the knee was the most commonly involved joint. The most common causative pathogen was Pseudomonas spp. (n Z 16, 33.3%), followed by Escherichia coli (n Z 13, 28.1%). Among the 29 clinical isolates of Enterobacteriaceae, eight (27.6%) were resistant to ceftriaxone and six (20.7%) were resistant to cefpirome. Three E. coli isolates and three Klebsiella pneumoniae isolates were extended-spectrum beta-lactamase producers (n Z 6, 20.7%). Among the nonfermenting GNB (NFGNB), 21.1% were resistant to ceftazidime, 21.1% were resistant to ciprofloxacin, 26.3% were resistant to piperacillin-tazobactam, and 15.8% were resistant to imipenem. The overall mortality rate was 10.4%, and the significant risk factors for death were concomitant bacteremia [odds ratio (OR): 14.6, 95% confidence interval (CI): 1.9-115.2, p Z 0.011] and liver cirrhosis (OR: 20.0, 95% CI: 2.4-169.9, p Z 0.006). Conclusion: Approximately 25% of cases of septic arthritis were due to GNB and resistance to commonly used antimicrobial agents was common. Liver cirrhosis and concomitant bacteremia were significant risk factors for death. Copyright | 2015, Taiwan Society of Microbiology.
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