Septic arthritis
Septic arthritis
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DOI：
10.1016/s0140-6736(97)09522-6
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发表时间：
1998-01-17
期刊：
影响因子：
168.9
通讯作者：
Goldenberg, DL
中科院分区：
文献类型：
--
作者：
Goldenberg, DL
SEMINAR系列中，金黄色葡萄球菌是40%来自英格兰和威尔士的病例、7.56%来自法国的病例、6%来自热带澳大利亚的病例和37%来自热带澳大利亚的病例中细菌性关节炎的主要原因2（第1组）。金黄色葡萄球菌引起并发类风湿关节炎和糖尿病患者80%的关节感染。这种微生物也是髋关节感染和多关节脓毒性关节炎的主要病原体。金黄色葡萄球菌阐述了几种细胞外和细胞介导的因子，这些因子可能是脓毒性关节炎中重要的毒力决定因子。兰斯菲尔德A组溶血性链球菌是从成人脓毒关节中分离出的第二常见细菌（图1）。B、C和G群链球菌是受损宿主或严重泌尿生殖道或胃肠道感染患者细菌性关节炎的重要原因。革兰氏阴性杆菌是静脉吸毒者、老年人和严重免疫功能低下的宿主中细菌性关节炎的常见原因。革兰氏阴性杆菌和流感嗜血杆菌是新生儿和所有5岁以下儿童中最常见的病原体。然而，流感嗜血杆菌细菌性关节炎不仅限于新生儿。虽然肺炎球菌性关节炎在过去的25年中并不常见，但在1990年至1993年的4年期间，英格兰和威尔士10%的细菌性关节炎是由以下原因引起的：
SEMINAR series, Staphylococcus aureus was the primary cause of bacterial arthritis in 40% of cases from England and Wales, 7 56% of cases from France, 6 and 37% of cases from tropical Australia2 (panel 1). S aureus cause 80% of joint infections in patients with concurrent rheumatoid arthritis and in those with diabetes. This microbe is also the primary pathogen in hip infections and in polyarticular septic arthritis. S aureus elaborate several extracellular and cell-mediated factors that may be important virulence determinants in septic arthritis. 8, 9 Lancefield group A-haemolytic streptococci are the next most common bacteria isolated from septic joints in adults (panel 1). Group B, C, and G streptococci are important causes of bacterial arthritis in compromised hosts or in patients with serious genitourinary or gastrointestinal infections. Gram-negative bacilli are common causes of bacterial arthritis in intravenous drug users, in the elderly, and in seriously immunocompromised hosts. Gram-negative bacilli and Haemophilus influenzae are the most common pathogens in the newborn and in all children under age 5 years. However, H influenzae bacterial arthritis is not limited to neonates. Although pneumococcal arthritis has been uncommon in most series during the past 25 years, 10% of bacterial arthritis from England and Wales over a 4 year period from 1990 to 1993 were caused by