The British Journal of Rheumatology, Vol 36, 370-373, Copyright © 1997 by British Society for Rheumatology
MJ Ryan, R Kavanagh, PG Wall and BL Hazleman
Data from 1158 cases of septic arthritis reported to the Public Health
Laboratory Service (PHLS) Communicable Disease Control Centre (CDSC) from
England and Wales over a 4 yr period (January 1990 December 1993) are
presented. Reports where a bacterial organism was isolated from synovial
fluid, or where an organism was isolated from blood cultures where a
diagnosis of septic arthritis was reported, were examined. Reports of
infection were more common in children (12.7% of infections were in the
under 10 age group) and the elderly (54.7% aged 60 or over), and were
higher in males in all age groups except in the elderly. The most common
causative organisms remain staphylococcal and streptococcal species,
comprising 40.6% (470) and 28% (324) of cases, respectively. The most
common streptococci seen were Streptococcus pneumoniae and Lancefield group
A beta-haemolytic Streptococcus organisms, 60.8% (197/324), although group
B, C and G organisms accounted for 33.6% of streptococcal isolates
(109/324). Haemophilus influenzae septic arthritis is not exclusive to
children as 23.2% (16- 69) of cases occurred over the age of 15. A total of
48% (635) of isolates were identified from both synovial fluid and blood
cultures, 32.6% (378) from joint fluid alone and 12.5% (146) from blood
cultures. Although this study excludes cases of septic arthritis where no
organism was isolated, it presents important bacteriological information
from a large number of isolates from England and Wales over a 4 yr period.
Risk factors identified include a joint prosthesis, joint
disease/connective tissue disorder. immunosuppression and diabetes.
ORIGINAL PAPERS
Bacterial joint infections in England and Wales: analysis of bacterial isolates over a four year period
PHLS Communicable Disease Surveillance Centre, London.
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