Ross Kathleen, Mehr Jason, Carothers Barbara, Greeley Rebecca, Benowitz Isaac, McHugh Lisa, Henry David, DiFedele Lisa, Adler Eric, Naqvi Shereen, Lifshitz Edward, Tan Christina, Montana Barbara
MMWR Morb Mortal Wkly Rep. 2017 Jul 28;66(29):777-779. doi: 10.15585/mmwr.mm6629a3.
On March 6, 2017, the New Jersey Department of Health (NJDOH) was notified of three cases of septic arthritis in patients who had received intra-articular injections for osteoarthritic knee pain at a private outpatient practice. The practice voluntarily closed the next day. NJDOH, in conjunction with the local health department and the New Jersey Board of Medical Examiners, conducted an investigation and identified 41 cases of septic arthritis associated with intra-articular injections administered during 250 patient visits at the same practice, including 30 (73%) patients who required surgery. Bacterial cultures of synovial fluid or tissue from 15 (37%) patients were positive; all recovered organisms were oral flora. An infection prevention assessment of the practice identified multiple breaches of recommended infection prevention practices, including inadequate hand hygiene, inappropriate use of pharmacy bulk packaged (PBP) products as multiple-dose containers and handling PBP products outside of required pharmacy conditions, and preparation of syringes up to 4 days in advance of their intended use. No additional septic arthritis cases were identified after infection prevention recommendations were implemented within the practice.
2017年3月6日，新泽西州卫生部（NJDOH）接到通知，在一家私人门诊接受骨关节炎膝关节疼痛关节内注射治疗的患者中出现了3例化脓性关节炎病例。该门诊于次日自愿关闭。NJDOH与当地卫生部门及新泽西州医学考试委员会联合进行了调查，确认在同一门诊250次患者就诊期间进行的关节内注射导致了41例化脓性关节炎病例，其中30例（73%）患者需要手术治疗。15例（37%）患者的滑膜液或组织细菌培养呈阳性；所有分离出的微生物均为口腔菌群。对该门诊的感染预防评估发现了多项违反推荐感染预防措施的行为，包括手卫生不足、不恰当地将药房散装包装（PBP）产品用作多剂量容器以及在规定药房条件之外处理PBP产品，以及在预期使用前提前多达4天准备注射器。在该门诊实施感染预防建议后，未发现其他化脓性关节炎病例。
