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Risk Factors, Screening, and Treatment Challenges in Staphylococcus aureus Native Septic Arthritis.

Abstract：

Background:Staphylococcus aureus is the most common cause of native septic arthritis. Few studies have characterized this disease during the US opioid epidemic. The role of methicillin-resistant Staphylococcus aureus (MRSA) nasal screening in this disease has not been elucidated. We sought to identify risk factors and outcomes for S. aureus native septic arthritis and to evaluate MRSA screening in this disease. Methods:A retrospective cohort study of native septic arthritis patients (2012-2016) was performed. Demographics, risk factors, and outcomes were compared between Staphylococcus aureus and other native septic arthritis infections. Sensitivity, specificity, and predictive values of MRSA screening were assessed. Results:Two hundred fifteen cases of native septic arthritis were included. S. aureus was cultured in 64% (138/215). MRSA was cultured in 23% (50/215). S. aureus was associated with injection drug use (odds ratio [OR], 4.33; 95% CI, 1.74-10.81; P = .002) and switching antibiotics (OR, 3.92; 95% CI, 1.01-21.38; P = .032). For every 10-year increase in age, the odds of S. aureus decreased (OR, 0.72; 95% CI, 0.60-0.87; P = .001). For 1-unit increases in Charlson comorbidity index score, the odds of S. aureus decreased (OR, 0.82; 95% CI, 0.73-0.91; P = .0004). MRSA screening during admission demonstrated a sensitivity of 0.59, specificity of 0.96, positive predictive value of 0.85, and negative predictive value of 0.84 for MRSA native septic arthritis. Conclusions:The opioid epidemic may be contributing to a demographic shift in native septic arthritis to younger, healthier individuals. S. aureus native septic arthritis has unique risks, including injection drug use. MRSA screening may be useful to rule in MRSA native septic arthritis.

journal_name

Open Forum Infect Dis

journal_title

Open forum infectious diseases

authors

Gobao VC,Alfishawy M,Smith C,Byers KE,Yassin M,Urish KL,Shah NB

doi

10.1093/ofid/ofaa593

subject

Has Abstract

pub_date

2020-12-18 00:00:00

pages

ofaa593

issue

1

issn

2328-8957

pii

ofaa593

journal_volume

8

pub_type

杂志文章

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