Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

AbstractFew studies on adult pneumococcal septic arthritis are sufficiently large enough to assess both epidemiological trends following routine pneumococcal immunization and clinical disease. With major shifts in serotypes causing invasive pneumococcal disease (IPD), we wanted to determine the clinical phenotype of adult septic arthritis caused by Streptococcus pneumoniae. We conducted a retrospective cohort study of pneumococcal infections in Bristol and Bath, UK, 2006-2018. We defined pneumococcal septic arthritis as adults with clinically-confirmed septic arthritis, with pneumococcus isolated from sterile-site culture or urinary antigen test positivity. Clinical records were reviewed for each patient in the cohort.Septic arthritis accounted for 1.7% of all IPD cases. 45 cases of adult pneumococcal septic arthritis occurred, with disease typically affecting older adults and those with underlying comorbidity. 67% patients had another focus of infection during their illness. 66% patients required increased care on discharge and 43% had reduced range of movement. In-hospital case fatality rate was 6.7%. One-year patient mortality was 31%.Currently most cases of adult pneumococcal septic arthritis are due to non-PCV13 serotypes which are associated with more severe disease. PCV13 serotypes had higher prevalence of concomitant pneumococcal infection at another site (36.6% versus 73.7%), increased intensive care or high-dependency unit requirement (0% versus 32.4%), and higher inpatient and 1-year case fatality rate (0% versus 8.8%, and 27.3% versus 32.4% respectively) compared to non-PCV13 serotypes.Pneumococcal septic arthritis remains a small proportion of IPD. However, there is significant associated morbidity and mortality, and pneumococcal septic arthritis requires monitoring in coming years.

Original publication

DOI

10.1080/22221751.2021.1945955

Type

Journal article

Journal

Emerg microbes infect

Publication Date

19/06/2021

Pages

1 - 26

Keywords

PCV-13 pneumococcal vaccines, Pneumococcus, Streptococcus pneumoniae, septic arthritis