Espersen F, Frimodt-Møller N, Thamdrup Rosdahl V, Skinhøj P, Bentzon M W
Staphylococcal Laboratory, State Serum Institute, Copenhagen, Denmark.
Rev Infect Dis. 1991 May-Jun;13(3):347-58. doi: 10.1093/clinids/13.3.347.
Of the 15,170 cases of bacteremia due to Staphylococcus aureus that occurred in Denmark between 1959 and 1988, we review 525 cases of acute hematogenous osteomyelitis and 185 cases of septic arthritis that developed subsequent to the bacteremia and 134 cases of contiguous osteomyelitis in which the bacteremia developed secondarily. The pattern of acute infections of bones and joints has changed over the three decades studied. The frequency of secondary bone or joint infections due to S. aureus bacteremia has changed, as have the phage-type pattern and antibiotic resistance of the infective strains. The prevalence of hospital-acquired cases has increased and the age distribution of patients has changed, as is reflected in an increasing number of older patients. The localization of hematogenous osteomyelitis has shifted, and the vertebral column is now the most common site of infection. The rate of chronic cases of osteomyelitis that occur following acute hematogenous osteomyelitis has been reduced from 34% to 6%. The mortality associated with S. aureus bacteremic infections of bones or joints is low compared to that associated with other cases of S. aureus bacteremia.
在1959年至1988年丹麦发生的15170例金黄色葡萄球菌菌血症病例中，我们回顾了525例菌血症后发生的急性血源性骨髓炎、185例脓毒性关节炎以及134例继发性菌血症的连续性骨髓炎病例。在所研究的三十年中，骨骼和关节的急性感染模式发生了变化。由金黄色葡萄球菌菌血症引起的继发性骨或关节感染的频率发生了变化，感染菌株的噬菌体类型模式和抗生素耐药性也发生了变化。医院获得性病例的患病率有所增加，患者的年龄分布也发生了变化，这体现在老年患者数量的增加上。血源性骨髓炎的感染部位发生了转移，脊柱现在是最常见的感染部位。急性血源性骨髓炎后发生的慢性骨髓炎病例的比例已从34%降至6%。与金黄色葡萄球菌菌血症的其他病例相比，与金黄色葡萄球菌菌血症性骨或关节感染相关的死亡率较低。
