Spectrum of Bacterial Infections in Rheumatology

Spectrum of Bacterial Infections in Rheumatology and the Role of Urinary Tract Infection

Retrospective study of patients with a proved non-tuberculous osteoarticular infection (OAI) diagnosed in a rheumatology department during the years 2010-2020. The objectives are :

• To describe sites, type of micro-organism, clinical data, origin of infection, therapeutic modalities et outcome
• To compare OAI of urinary origin with those with another origin

This retrospective study will be conducted on medical files. Patients will be mainly selected on :

• A proved osteoarticular infection (OAI) diagnosed in the department of rheumatology of the René Dubos hospital from 1° January 2010 to 31 December 2020.
• Adult patients 18 year's old or older
• Infection proved by positive culture in the osteoarticular site and/or blood (with typical clinical and imaging features)

The followed OAI are not included :

• Infection on prosthetic joint, materiel ; post-operative OAI ; osteomyelitis
• Brucellosis ; Lyme disease

Patients are selected from the codification of the hospitalization ; medical files are reviewed by the investigators.

OAI of urinary origin is defined either by the same micro-organism in urine and osteo-articular sample (or blood) or a bacteria in the osteo-articular sample in conjunction with : urologic pathology, recurrent urinary tract infection, urologic surgery, antibiotic therapy.

• Characteristics of three populations will be compared :
• - OAI of urinary origin
• - OAI of another origin (skin, etc)
• - OAI without known origin Characteristics include : gender, age, risk factors, site of osteo-articular infection, type of micro-organism, type of positive sample(s), blood cultures, urinary cultures, duration of symptoms, site of primary infection and/or type of contamination, biological results, echocardiography, imaging results, type of treatment (medical, surgical), outcome, duration of hospitalization, intensive unit care stay, death at hospital.

Inclusion Criteria:

• Subject aged 18 years and over at the time of diagnosis
• Osteoarticular infection (septic arthritis, spondylodiscitis), by a bacterium or a fungus, proven by a bacteriological sample in situ or in the blood by positive blood culture (with an unequivocal clinical, biological and imaging feature),
• Diagnosed between 01/01/2010 and 12/31/2020 (11 years)
• Hospitalization in the rheumatology department of CH René Dubos, Pontoise

Exclusion Criteria:

• Bacterial infection due to the following germs: mycobacteria, brucella, Borrelia
• Early infection on joint prosthesis
• Peripheral osteomyelitis
• Osteoarticular infection without bacteriological proof