Incidence and sources of native and prosthetic joint infection: a community based prospective survey

• Published in: Annals of the rheumatic diseases Vol. 56; no. 8; pp. 470 - 475
• Main Authors: Kaandorp, Carola J E, Dinant, Huibert J, van de Laar, Mart A F J, Moens, Hein J Bernelot, Prins, A Pieter A, Dijkmans, Ben A C
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.08.1997; BMJ; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Antibiotics; Arthritis; Arthritis, Infectious - epidemiology; bacterial arthritis; Bacterial arthritis and osteitis; Bacterial diseases; Biological and medical sciences; Child; Community-Acquired Infections - epidemiology; Disease prevention; epidemiology; Extended Reports; Female; Human bacterial diseases; Humans; Incidence; Infections; Infectious diseases; Male; Medical sciences; Microorganisms; Middle Aged; Netherlands - epidemiology; Patients; Penicillin Resistance; prevention; Prospective Studies; Prostheses; Prosthesis-Related Infections - epidemiology; prosthetic joint infection; Staphylococcal Infections - complications; Staphylococcus aureus; Surgical Wound Infection - complications; Netherlands; Staphylococcus aureus; Human; Prosthesis; Surgery; Diseases of the osteoarticular system; Etiopathogenesis; Arthropathy; Arthritis; Biological effect; Joint; Statistical study; Incidence
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.56.8.470

OBJECTIVES To determine the incidence and sources of bacterial arthritis in the Amsterdam health district and the maximum percentage of cases that theoretically would be preventable. METHODS Patients with bacterial arthritis diagnosed between 1 October 1990 and 1 October 1993 were prospectively reported to the study centre by all 12 hospitals serving the district. Data were gathered on previous health status, source of infection, and microorganisms involved. RESULTS 188 episodes of bacterial arthritis were found in 186 patients. Most of the 38 children were previously healthy. Fifty per cent of the adults were 65 years or older. Of the adults 84% had an underlying disease, in 59% a joint disorder. Joint surgery constituted the largest part of direct infections (33%) and skin defects were the most important source of haematogenous infections (67%). Infection of joints containing prosthetic or osteosynthetic material by a known haematogenous source occurred 15 times (8%).Staphylococcus aureus was the causative organism in 44% of all positive cultures. CONCLUSION The incidence of bacterial arthritis was 5.7 per 100 000 inhabitants per year. Preventive measures directed to patients with prosthetic joints or osteosynthetic material, and a known haematogenous source would have prevented at most 8% of all cases.