Factors associated with early clinical outcomes of septic arthritis treated at the adult university teaching hospital, Lusaka.

Abstract

Septic arthritis refers to an infection involving the joint. Management of these patients involves prompt diagnosis, surgical treatment and antibiotics. Delay in treatment could result in poor functional outcome and severe cases fatality. Antibiotic treatment requires knowledge of the local microbiological profile of this disease. Furthermore, outcomes of this disease vary and may depend on different demographic and clinical characteristics of patients presenting with septic arthritis. This set out to determine local microbiological profile as well as the early functional outcome following septic arthritis at the University Teaching Hospital, Lusaka, Zambia. A prospective cross-sectional study was conducted at the University Teaching Hospital, Lusaka, Zambia from July 2019 to March 2020. A total of 33 patients with septic arthritis of all age groups were recruited. Demographic characteristics, clinical presentation and laboratory findings including microbiological profile were elicited. Participants had joint range of motion and weight-bearing assessed at six and twelve weeks. The patients' age ranged from 5 to 72 years, with a median age of 23 and the majority, 75.8% (n=25) were males. Most patients came from high density areas 57.6% (n=19), did not go beyond primary level of education 78.8% (n=26) and were from moderately poor background 66.7% (n=22). Trauma was commonest predisposing factor 33.3% (n=11), and the knee was commonest joint affected 45.4% (n=15). The median duration of symptoms reported was nine days. Cultures were positive in 63.6% (21), and S aureus accounted for 85.6% (n=18), of which 50% were MRSA. Most patients were full weight-bearing at 12-week follow up 75.8% (n=25). Elbow and shoulder joints had marked a reduced range of motion. Age was the only variable that had a significant association with the functional outcome of multivariable logistic regression. Septic arthritis had debilitating outcome in all age groups with a high prevalence of MRSA at our institution. Septic arthritis of the shoulder and elbow joints were associated with significant loss of range of motion. Older age was associated with delayed return to function of the affected limb. Keywords: Septic arthritis, Methicillin-resistant Staphylococcus aureus, range of motion, weight-bearing