Print E-mail
Volume 42, Number 3, June 2009

Characteristics and outcomes of community-onset septic arthritis in adults

Yu-Chung Chuang, Jiun-Ling Wang, Yee-Chun Chen, Shan-Chwen Chang
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

Received: May 1, 2008    Revised: June 8, 2008    Accepted: July 15, 2008   


Corresponding author:

Dr. Shan-Chwen Chang, Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Rd., Taipei 100, Taiwan. E-mail: Dr. Shan-Chwen Chang This e-mail address is being protected from spam bots, you need JavaScript enabled to view it


Background and purpose: 

Failure to recognize and to appropriately treat septic arthritis results in substantial morbidity rates. This study compared the demographic characteristics, risk factors, and outcomes of patients with community-onset septic arthritis due to Gram-positive and Gram-negative bacteria.




The medical charts of 51 adults with culture-proven community-onset septic arthritis treated at a tertiary medical center in northern Taiwan from January 1, 2004 through December 31, 2007 were retrospectively reviewed. The demographic data and clinical features were analyzed.



There were 39 patients with septic arthritis caused by Gram-positive cocci (76.4%) and 12 with septic arthritis caused by Gram-negative bacteria (23.6%). The most common pathogen was Staphylococcus aureus (n = 30; 58.9%). The most frequently involved joint was the knee (n = 33; 63.5%). By multivariate logistic regression analysis, age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.01-1.13; p = 0.024) and range of motion limitation (OR, 8.23; 95% CI, 1.14-59.49; p = 0.037) were independent predictive factors for septic arthritis caused by Gram-positive cocci. Diabetes mellitus with end-organ damage (OR, 0.03; 95% CI, 0.00-0.39; p = 0.007) and malignancy (OR, 0.04; 95% CI, 0.00-0.66; p = 0.025) were negative predictive factors for septic arthritis caused by Gram-positive cocci. There were no significant differences in outcomes for patients with Gram-positive and Gram-negative septic arthritis.



In adult patients with community-onset septic arthritis, older age and limited range of motion predict for Gram-positive cocci as the causative pathogen, while underlying diabetes mellitus with end-organ damage and malignancy predict for Gram-negative bacteria as the causative pathogen.


Key words:

 Arthritis, infectious; Diabetes mellitus; Gram-negative bacteria; Gram-positive cocci; Neoplasms



J Microbiol Immunol Infect. 2009;42:258-264.