Helito Camilo Partezani, Teixeira Paulo Renan Lima, Oliveira Priscila Rosalba de, Carvalho Vladimir Cordeiro de, Pécora José Ricardo, Camanho Gilberto Luis, Demange Marco Kawamura, Lima Ana Lucia Munhoz
Faculdade de Medicina da Universidade de São Paulo, Departamento de Ortopedia e Traumatologia, Divisão de Cirurgia do Joelho, Sa˜o Paulo/SP Brazil.
Faculdade de Medicina da Universidade de São Paulo, Departamento de Ortopedia e Traumatologia, Divisa˜o de Doenc¸as Infecciosas, Sa˜o Paulo/SP Brazil.
Clinics (Sao Paulo). 2016 Dec 1;71(12):715-719. doi: 10.6061/clinics/2016(12)07.
: To clinically and epidemiologically characterize a population diagnosed with and treated for septic arthritis of the knee, to evaluate the treatment results and to analyze the differences between patients with positive and negative culture results, patients with Gram-positive and Gram-negative bacterial isolates and patients with S. aureus- and non-S. aureus-related infections.
: One hundred and five patients with septic knee arthritis were included in this study. The clinical and epidemiological data were evaluated. Statistical analysis was performed to compare patients with and without an isolated causative agent, patients with Gram-positive and Gram-negative pathogens and patients with S. aureus-related and non S. aureus-related infections.
: Causative agents were isolated in 81 patients. Gram-positive bacteria were isolated in 65 patients and Gram-negative bacteria were isolated in 16 patients. The most commonly isolated bacterium was S. aureus. Comparing cases with an isolated pathogen to cases without an isolated pathogen, no differences between the studied variables were found except for the longer hospital stays of patients in whom an etiological agent was identified. When comparing Gram-positive bacteria with Gram-negative bacteria, patients with Gram-positive-related infections exhibited higher leukocyte counts. Patients with S. aureus-related infections were more frequently associated with healthcare-related environmental encounters.
: S. aureus is the most common pathogen of septic knee arthritis. Major differences were not observed between infections with isolated and non-isolated pathogens and between infections with Gram-positive and Gram-negative bacteria. S. aureus infections were more likely to be associated with a prior healthcare environment exposure.
对诊断为膝部化脓性关节炎并接受治疗的人群进行临床和流行病学特征分析，评估治疗效果，并分析培养结果为阳性和阴性的患者、革兰氏阳性菌和革兰氏阴性菌分离株患者以及金黄色葡萄球菌相关和非金黄色葡萄球菌相关感染患者之间的差异。
本研究纳入了105例膝部化脓性关节炎患者。对临床和流行病学数据进行评估。进行统计分析以比较有和没有分离出致病病原体的患者、革兰氏阳性菌和革兰氏阴性菌病原体患者以及金黄色葡萄球菌相关和非金黄色葡萄球菌相关感染患者。
81例患者分离出致病病原体。65例患者分离出革兰氏阳性菌，16例患者分离出革兰氏阴性菌。最常分离出的细菌是金黄色葡萄球菌。将有分离出病原体的病例与没有分离出病原体的病例进行比较，除了确定病原体的患者住院时间较长外，在所研究的变量之间未发现差异。比较革兰氏阳性菌和革兰氏阴性菌时，革兰氏阳性菌相关感染的患者白细胞计数较高。金黄色葡萄球菌相关感染的患者更常与医疗保健相关的环境接触有关。
金黄色葡萄球菌是膝部化脓性关节炎最常见的病原体。在有和没有分离出病原体的感染之间以及革兰氏阳性菌和革兰氏阴性菌感染之间未观察到主要差异。金黄色葡萄球菌感染更可能与先前的医疗保健环境暴露有关。
