To evaluate the clinical characteristics and outcomes of patients with naïve septic arthritis caused by methicillin-resistant Staphylococcus aureus (MRSA).
We conducted a retrospective review of adult patients with naïve septic arthritis at three tertiary-care hospitals from 2005 through 2017.
Of the 101 patients with S. aureus naïve septic arthritis, 39 (38.6%) was identified MRSA. Compared to patients with methicillin-susceptible Staphylococcus aureus (MSSA), patients with MRSA presented more frequently with nosocomial infection (1.6% vs. 17.9%; p=0.005), and inappropriate antibiotics within 48h (0% vs. 74.4%; p<0.001). The overall 30-day mortality was 4% and tended to be higher in MRSA group (1.6% vs. 7.7%; p=0.296). The treatment failure was 23.8%, which was higher in MRSA group (35.9% vs. 16.1%; p=0.031). The independent risk factors for treatment failure were end-stage of renal disease with hemodialysis (odds ratio [OR] = 32.073; 95% confidence interval [CI]: 2.669-385.372; p=0.006) and antibiotics duration less than 6 weeks (OR = 4.987; 95% CI: 1.204-20.662; p=0.027)
MRSA septic arthritis was associated with more frequent nosocomial infection and delayed treatment compared to MSSA septic arthritis. Antibiotic therapy, for less than 6 weeks, may be cautioned for S aureus septic arthritis until better outcomes are assured.
S. Y. Park, None