INCIDENCE AND SOURCES OF NATIVE AND PROSTHETIC JOINT INFECTION - A COMMUNITY-BASED PROSPECTIVE SURVEY

Objectives-To determine the incidence and sources of bacterial arthrit is in the health district and the percentage of cases that theoretical ly would be preventable. Methods-Patients with bacterial arthritis dia gnosed between 1 October 1990 and 1 October 1993 were prospectively re ported to the study centre by all 12 hospitals serving the district. D ata were gathered on previous health status, source of infection, and microorganisms involved. Results-188 episodes of bacterial arthritis w ere found in 186 patients. Most of the 38 children were previously hea lthy. Fifty per cent of the adults were 65 years or older. Of the adul ts 84% had an underlying disease, in 59% a joint disorder. Joint surge ry constituted the largest part of direct infections (33%) and skin de fects were the most important source of haematogenous infections (67%) . Infection of joints containing prosthetic or osteosynthetic material by a known haematogenous source occurred 15 times (8%). Staphylococcu s aureus was the causative organism in 44% of all positive cultures. C onclusion-The incidence of bacterial arthritis was 5.7 per 100 000 inh abitants per year. Preventive measures directed to patients with prost hetic joints or osteosynthetic material, and a known haematogenous sou rce would have prevented at most 8% of all cases.