Hamdad Farida, El Bayeh Nadim, Auger Gabriel, Peuchant Olivia, Wallet Frédéric, Ruimy Raymond, Reibel Florence, Martin Christian, Ploy Marie-Cécile, Robin Frédéric, Laurens Chrislène, Lanotte Philippe, Kempf Marie, Tetu Jennifer, Revillet Hélène, Patry Isabelle, Cailloux Philippe, Azouaou Mélissa, Varon Emmanuelle, Duhaut Pierre, Lozniewski Alain, Cattoir Vincent
Emerg Infect Dis. 2025 Jan;31(1):8-17. doi: 10.3201/eid3101.240321.
Streptococcus pneumoniae infection is considered an uncommon cause of arthritis in adults. To determine the clinical and microbiological characteristics of pneumococcal septic arthritis, we retrospectively studied a large series of cases among adult patients during the 2010-2018 conjugate vaccine era in France. We identified 110 patients (56 women, 54 men; mean age 65 years), and cases included 82 native joint infections and 28 prosthetic joint infections. Most commonly affected were the knee (50/110) and hip (25/110). Concomitant pneumococcal infections were found in 37.2% (38/102) and bacteremia in 57.3% (55/96) of patients, and underlying conditions were noted for 81.4% (83/102). Mortality rate was 9.4% (8/85). The proportion of strains not susceptible to penicillin was 29.1% (32/110). Of the 55 serotyped strains, 31 (56.4%) were covered by standard pneumococcal vaccines; however, several nonvaccine serotypes (mainly 23B, 24F, and 15A) had emerged, for which susceptibility to β-lactams was low.
肺炎链球菌感染被认为是成人关节炎的罕见病因。为了确定肺炎球菌性脓毒性关节炎的临床和微生物学特征，我们回顾性研究了法国2010 - 2018年结合疫苗时代成年患者中的一大系列病例。我们确定了110例患者（56名女性，54名男性；平均年龄65岁），病例包括82例天然关节感染和28例人工关节感染。最常受累的是膝关节（50/110）和髋关节（25/110）。37.2%（38/102）的患者伴有肺炎球菌感染，57.3%（55/96）的患者有菌血症，81.4%（83/102）的患者有基础疾病。死亡率为9.4%（8/85）。对青霉素不敏感的菌株比例为29.1%（32/110）。在55株分型菌株中，31株（56.4%）可被标准肺炎球菌疫苗覆盖；然而，出现了几种非疫苗血清型（主要是23B、24F和15A），它们对β-内酰胺类药物的敏感性较低。
