Pneumococcal Septic Arthritis among Adults, France, 2010-2018

• Published in: Emerging infectious diseases 2025-01, Vol.31 (1), p.8-17
• Main Authors: Hamdad, Farida, El Bayeh, Nadim, Auger, Gabriel, Peuchant, Olivia, Wallet, Frédéric, Ruimy, Raymond, Reibel, Florence, Martin, Christian, Ploy, Marie-Cécile, Robin, Frédéric, Laurens, Chrislène, Lanotte, Philippe, Kempf, Marie, Tetu, Jennifer, Revillet, Hélène, Patry, Isabelle, Cailloux, Philippe, Azouaou, Mélissa, Varon, Emmanuelle, Duhaut, Pierre, Lozniewski, Alain, Cattoir, Vincent
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Arthritis, Infectious - drug therapy; Arthritis, Infectious - epidemiology; Arthritis, Infectious - microbiology; bacteria; Female; France; France - epidemiology; Humans; joint infection; Male; Microbial Sensitivity Tests; Middle Aged; Pneumococcal Infections - drug therapy; Pneumococcal Infections - epidemiology; Pneumococcal Infections - microbiology; Pneumococcal Septic Arthritis among Adults, France, 2010–2018; Pneumococcal Vaccines - immunology; Retrospective Studies; septic arthritis; Serogroup; Streptococcus pneumoniae; Streptococcus pneumoniae - classification; Streptococcus pneumoniae - drug effects; Streptococcus pneumoniae - immunology; Streptococcus pneumoniae - isolation & purification
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid3101.240321

Streptococcus pneumoniae infection is considered an uncommon cause of arthritis in adults. To determine the clinical and microbiological characteristics of pneumococcal septic arthritis, we retrospectively studied a large series of cases among adult patients during the 2010-2018 conjugate vaccine era in France. We identified 110 patients (56 women, 54 men; mean age 65 years), and cases included 82 native joint infections and 28 prosthetic joint infections. Most commonly affected were the knee (50/110) and hip (25/110). Concomitant pneumococcal infections were found in 37.2% (38/102) and bacteremia in 57.3% (55/96) of patients, and underlying conditions were noted for 81.4% (83/102). Mortality rate was 9.4% (8/85). The proportion of strains not susceptible to penicillin was 29.1% (32/110). Of the 55 serotyped strains, 31 (56.4%) were covered by standard pneumococcal vaccines; however, several nonvaccine serotypes (mainly 23B, 24F, and 15A) had emerged, for which susceptibility to β-lactams was low.