Clinical characteristics, treatment outcomes, and factors associated with gram-positive and gram-negative bacterial septic arthritis at NongKhai Hospital
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Abstract
This retrospective descriptive study collects data from the medical records of patients with septic arthritis who have been eligible for Newman criteria level A or B from 2016-2023. The objective is to study the clinical characteristics, treatment outcomes, and factors associated with gram-positive and gram-negative bacterial septic arthritis at NongKhai Hospital. Categorical variables were compared using the Chi-square or Fisher’s exact test, and continuous variables with the Unpaired T-test or Mann–Whitney U-test, then only the factors with p < 0.10 were further analyzed using multiple logistic regression. 126 eligible patients were enrolled. Patients with bacterial septic arthritis were classified into gram-positive 90 cases (71.4%) and gram-negative 36 cases (28.6%). Most gram-negative patients were caused by Burkholderia pseudomallei (20 cases, 15.9%) and usually work as laborers, farmers, or agricultural workers (p=0.025, adjusted OR 3.140), have liver disease
(p = 0.090, adjusted OR 2.898), fever (p = 0.117, adjusted OR 2.633), septicemia (p = 0.199, adjusted OR 2.014), and intubation (p = 0.160, adjusted OR 2.365). Whereas gram-positive patients often have a joint disease (p = 0.025, adjusted OR 0.241). In conclusion, according to this study, it is recommended that patients with bacterial septic arthritis particularly those with concomitant liver disease and suspected septicemia who work as laborers, farmers, or agricultural workers, should consider empirical antibiotics for gram-negative bacteria, especially melioidosis. In a while, patients with bacterial septic arthritis who have a concomitant joint disease should consider empirical antibiotics for gram-positive bacteria.
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