Bacterial septic arthritis infections associated with intra-articular injection practices for osteoarthritis knee pain-New Jersey, 2017.

Publisher: Cambridge University Press Country of Publication: United States NLM ID: 8804099 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1559-6834 (Electronic) Linking ISSN: 0899823X NLM ISO Abbreviation: Infect Control Hosp Epidemiol Subsets: MEDLINE

Publication: Jan. 2015- : Cambridge : Cambridge University Press
Original Publication: [Thorofare, N.J. ] : SLACK Inc., c1988-

Equipment Contamination*; Arthritis, Infectious/*etiology ; Bacterial Infections/*etiology ; Injections, Intra-Articular/*adverse effects ; Osteoarthritis, Knee/*drug therapy; Disease Outbreaks ; Humans ; New Jersey

Background: In March 2017, the New Jersey Department of Health received reports of 3 patients who developed septic arthritis after receiving intra-articular injections for osteoarthritis knee pain at the same private outpatient facility in New Jersey. The risk of septic arthritis resulting from intra-articular injection is low. However, outbreaks of septic arthritis associated with unsafe injection practices in outpatient settings have been reported.
Methods: An infection prevention assessment of the implicated facility's practices was conducted because of the ongoing risk to public health. The assessment included an environmental inspection of the facility, staff interviews, infection prevention practice observations, and a medical record and office document review. A call for cases was disseminated to healthcare providers in New Jersey to identify patients treated at the facility who developed septic arthritis after receiving intra-articular injections.
Results: We identified 41 patients with septic arthritis associated with intra-articular injections. Cultures of synovial fluid or tissue from 15 of these 41 case patients (37%) recovered bacteria consistent with oral flora. The infection prevention assessment of facility practices identified multiple breaches of recommended infection prevention practices, including inadequate hand hygiene, unsafe injection practices, and poor cleaning and disinfection practices. No additional cases were identified after infection prevention recommendations were implemented by the facility.
Discussion: Aseptic technique is imperative when handling, preparing, and administering injectable medications to prevent microbial contamination.
Conclusions: This investigation highlights the importance of adhering to infection prevention recommendations. All healthcare personnel who prepare, handle, and administer injectable medications should be trained in infection prevention and safe injection practices.

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CC999999 United States ImCDC Intramural CDC HHS

Date Created: 20190718 Date Completed: 20200513 Latest Revision: 20210312

20240829

PMC7950910

10.1017/ice.2019.168

31311611