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Updated: Apr 27, 2026
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Three-decade trends in the distribution of organisms causing septic arthritis in native joints: single-center study
Jean-Jacques Dubost1, Marion Couderc1, Zuzana Tatar1
1Service de Rhumatologie, Hôpital G.-Monpied, Université Clermont-Ferrand 1, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 1, France.
Objective:
A rise in the incidence of septic arthritis due to methicillin-resistant Staphylococcus aureus (MRSA) has been reported in several parts of the world. Here, our objective was to look for changes over the last 30years in the distribution and antibiotic susceptibility profiles of organisms responsible for septic arthritis.
Methods:
We conducted a single-center retrospective study of all cases of septic arthritis documented by joint specimens and/or blood cultures between 1979 and 2008. Prosthetic joint infections were excluded.
Results:
We enrolled 374 patients, of whom 127, 136, and 111 were included during each decade, respectively. We detected no significant time trends in the proportions of staphylococci (67%, 65%, and 64%), streptococci (14%, 21%, and 17%), or Gram-negative rods (7%, 10%, and 14%). Tuberculosis was more common during the earliest decade (1979-1988, n=10, 4, 2%; P<0.05). No significant changes occurred in the proportions of methicillin-resistant staphylococci or MRSA (13%, 11%, 15%). Age and prevalence of risk factors for infection increased over time.
Conclusion:
The distribution and susceptibility of organisms causing septic arthritis has changed little over time. Our findings do not support the use of broader-spectrum antibiotics when empirical treatment is deemed necessary at our center.
Insights
Septic arthritis pathogen distribution and antibiotic susceptibility remained largely unchanged over 30 years. Findings suggest current empirical antibiotic strategies are appropriate for treating septic arthritis.
Area of Science:
- Infectious Diseases
- Microbiology
- Rheumatology
Background:
- Septic arthritis incidence, particularly due to methicillin-resistant Staphylococcus aureus (MRSA), is a growing global concern.
- Understanding trends in causative organisms and their antibiotic resistance is crucial for effective treatment.
Purpose of the Study:
- To analyze changes in the distribution and antibiotic susceptibility of pathogens causing septic arthritis over a 30-year period.
- To inform empirical antibiotic treatment strategies for septic arthritis.
Main Methods:
- A single-center retrospective study analyzed joint specimens and blood cultures from 1979 to 2008.
- Prosthetic joint infections were excluded from the analysis.
- 374 patients with septic arthritis were included.
Main Results:
- No significant temporal trends were observed in the proportions of staphylococci, streptococci, or Gram-negative rods.
- The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) remained stable.
- Tuberculosis was more frequent in the earliest decade (1979-1988).
- Patient age and risk factors for infection increased over time.
Conclusions:
- The etiological agents and antibiotic susceptibility patterns of septic arthritis have shown minimal change over three decades.
- The study does not support the use of broader-spectrum antibiotics for empirical treatment of septic arthritis at this center.
