neo235 wrote:
E.coli is most common cause of septic arthritis in i.v drug abusers.....according to UW.
    
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| Doc750
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ok I just went and found the question on world. The explanation says "staph aureus is mcc of septic arthritis, and in IVDA, e coli and pseud. are commonly isolated" ... it doesn't say in IVDA e coli is MCC of septic arthritis, just that it along with pseud is commonly found. so unless they give lab findings indicating e. coli or pseudo .. I would stick with staph even in ivda
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| me007
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microbiology of nongonococcal arthritis
85% gram-positive
10-15% gram-neg - definitely not most common
5% polymicrobal
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| neo235
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yep there r 2 UW Q
IN one Q he says as u said Doc750.......that most staph is most common in i.v drug abusers......and that most commonly isolated ones r e.coli and pseudomonas
in another Q it says E.coli is most common cause of septic arthritis in i.v drug abusers
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| me007
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http://www.medscape.com/viewarticle/534822
Intravenous Drug Abusers
Intravenous drug abusers are at risk for repetitive transient bacteremia and direct bacterial inoculation of soft tissue. Bacteremia is thought to be the most common mechanism of infection. Although medium to large joints (such as the wrist and knee) are most commonly involved, fibrocartilaginous joints (sternoclavicular, sacroiliac) and the spine are frequently infected. Gram-positive organisms (especially S. aureus and MRSA) are the most common pathogens,27 followed by gram-negative bacteria (Enterobacter, Serratia, and P. aeruginosa).
http://www.medscape.com/viewarticle/534821
Comorbid medical conditions, prior antibiotic use, and extra-articular infections (particularly urinary tract infections and decubitus ulcers) predispose to gram-negative septic arthritis. Reviews of septic arthritis in intravenous drug abusers over the past decade report a lower percentage of gram-negative pathogens than were reported in earlier series, in which organisms such as Enterobacter, Klebsiella, Serratia, and P. aeruginosa accounted for more than 80% of infections.27 Pathogens and sensitivities associated with intravenous drug abuse are specific to geographic regions, and choice of antimicrobial therapy for this patient subgroup must take these factors into account.
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