Department of Medicine of Sensory and Motor Organs, Division of Orthopaedic Surgery, Faculty of Medicine, Tottori University, 36-1 Nishi-machi, Yonago, Tottori 683-8504, Japan.
J Infect Chemother. 2011 Oct;17(5):666-70. doi: 10.1007/s10156-011-0244-z. Epub 2011 May 17.
This study was a retrospective analysis of 53 adult patients with septic arthritis (SA) of the knee or hip treated during the years from 1955 to 2005 in Tottori University Hospital in Japan. Patients with postoperative infection, infection caused by trauma, and periprosthetic infection were excluded. The 50-year period between 1955 and 2005 was divided into five periods: there were 5 patients in the first decade, 9 in the second decade, 11 in the third decade, 10 in the fourth decade, and 18 in the fifth decade. All SA occurred in the knee until the fourth decade. Five cases of septic arthritis in the hip occurred in the fifth decade. In contrast to the decrease in direct infections (post intraarticular injection), hematogenous infections were observed to increase after 1986. The rate of SA caused by Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus, MRSA) had been highest during the 50 years. Infections caused by MRSA, comprising 22% of all staphylococcal infection, occurred in the fifth decade. The numbers of patients with comorbid conditions such as diabetes increased during the 50-year period. This study indicated that patients with SA have been increasing in number. Furthermore, hematogenous SA has been increasing. The increase in occurrence of SA could result from increase in opportunistic infection, occurrence of SA of the hip, and increase in MRSA infection.
本研究回顾性分析了 1955 年至 2005 年在日本鸟取大学医院治疗的 53 例膝关节或髋关节化脓性关节炎（SA）的成年患者。排除术后感染、创伤引起的感染和假体周围感染的患者。1955 年至 2005 年的 50 年期间分为五个时期：第一个十年有 5 例，第二个十年有 9 例，第三个十年有 11 例，第四个十年有 10 例，第五个十年有 18 例。所有的 SA 都发生在膝关节，直到第四个十年。第五个十年发生了 5 例髋关节化脓性关节炎。与直接感染（关节内注射后）减少相反，1986 年后观察到血源性感染增加。金黄色葡萄球菌（包括耐甲氧西林金黄色葡萄球菌，MRSA）引起的 SA 率在 50 年间一直最高。由 MRSA 引起的感染占所有葡萄球菌感染的 22%，发生在第五个十年。合并糖尿病等合并症的患者数量在 50 年间有所增加。本研究表明，SA 患者的数量一直在增加。此外，血源性 SA 也在增加。SA 发生率的增加可能是由于机会性感染的增加、髋关节 SA 的发生以及 MRSA 感染的增加所致。
