Bacterial etiology and antibiotic resistance pattern of septicarthritis in ۲۱۶ patients admitted to Imam Reza Hospital, Mashhad: a ۶-year retrospective study

Background and Aim : Septic arthritis is a medical emergency potentially associated withsignificant complications and disability, and as such requires prompt intervention includingempiric antibiotic therapy guided by regionally validated etiologic and antimicrobial susceptibilitydata.Methods : In this retrospective cross-sectional study, we reviewed the medical records of allpatients admitted to Imam Reza Hospital, Mashhad with a diagnosis of septic arthritis from March۲۰۱۱ to March ۲۰۱۶. This study evaluates demographic, clinical, and paraclinical data, includingculture and antibiogram results, and additionally compares these between pediatric (<۱۵ years old)and adult (≥۱۵ years old) age groups.Results : A total of ۲۱۶ patients were included. Of these, ۱۵۸ (۷۳.۱%) were ۱۵ years of age orolder, and ۵۸ (۲۶.۹%) were under ۱۵ (mean age ۴۲.۲۲±۲۷.۵۳). ۱۳۵ (۶۲.۵%) were male and ۸۱(۳۷.۵%) were female. The knee was the most commonly affected joint in both age groups, followedby the hip. The knee was more commonly involved in adults than in children, and the hip morecommonly involved in children than in adults (p<۰.۰۰۱). Additionally, positive blood cultureresults were higher in children than in adults (p=۰.۰۴۴). The most commonly isolated organismfrom joint fluid in both age groups was Staphylococcus aureus, which displayed the greatest rateof susceptibility to, in order, ceftriaxone, linezolid, gentamicin, and cefoxitin (۱۰۰% of S. aureusisolates), followed by vancomycin (۹۸% of isolates), clindamycin (۹۱% of isolates), anderythromycin (۸۶% of isolates). The highest rates of resistance were seen with penicillin (۱۰۰% ofS. aureus isolates) and imipenem (۵۰% of isolates).Conclusion : The organism most commonly responsible for septic arthritis in both children andadults was Staphylococcus aureus, with the highest rates of susceptibility to ceftriaxone, linezolid,gentamicin, and cefoxitin, and the highest rates of resistance to penicillin and imipenem. Theseresults should be considered in the choice of empiric antibiotic therapy for septic arthritis beforeaccess to patient-specific culture and antibiogram results.

کلیدواژه ها:

septic arthritis ، antibiotic resistance ، children ، adults