SEPTIC ARTHRITIS: BACTERIOLOGICAL PROFILE AND ANTIBIOTIC RESISTANCE STATUS: EXPERIENCE OF THE AVICENNE MILITARY HOSPITAL IN MARRAKECH

Septic arthritis is a therapeutic emergency and any delay in diagnosis has a serious impact on the patient's future, both in functional and vitality terms. Objectives: The aim of this study is to determine the epidemiology of septic arthritis, to characterize their bacteriological profiles and to evaluate antibiotic resistance in the Avicenne military hospital in Marrakech. Methods: This is a retrospective descriptive study over a period of 7 years from January 2014 to December 2020, focusing on the bacteriological analysis of articular liquids received in the microbiology laboratory of the Avicenne military hospital in Marrakech. Results: Among the 496 articular liquids studied, only 25 were positive on direct examination and/or culture. The male sex was predominant with a sex ratio of 5.25. The departments involved were: 48% from the rheumatology department, 16% from the trauma department, 8% from the emergency department, 4% from the resuscitation department, and 20% from the outpatient department. A purulent aspect on macroscopic examination is the most frequent finding at 88%. Hyperleukocytosis greater than 10000 elements/mm³ is found in 60% of cases. Direct examination is positive in 60% of cases, of which 44% are gram positive cocci and 16% are gram negative bacilli. Staphylococcus aureus is isolated in 45% of the cultures against 20% for coagulase-negative Staphylococci, 15% for streptococcus spp, 10% for Klebsiella pneumoniae, and 5% for Escherichia. Coli. However, the existence of a germ in the joint fluid is not synonymous with septic arthritis; in fact, we found 3 cases of joint fluid contamination. The study of the resistance of these isolates revealed an absence of resistance to methicillin for Staphylococcus aureus while 33% of coagulase-negative Staphylococcus were resistant. During the study period, out of a total of 20 bacteria isolated, only one multi-resistant bacterium was isolated (ESBL-producing enterobacteria). Conclusion: Septic arthritis is a serious infection. Bacteriological diagnosis of the articular liquid remains today the key to determine the infectious origin of arthritis and its treatment