{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T18:54:21Z","timestamp":1788288861891,"version":"build-2803163510"},"reference-count":23,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T00:00:00Z","timestamp":1563321600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X19001685_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X19001685_as2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>An infection prevention assessment of the implicated facility\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X19001685_as3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X19001685_as4\">\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Aseptic technique is imperative when handling, preparing, and administering injectable medications to prevent microbial contamination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X19001685_as5\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2019.168","type":"journal-article","created":{"date-parts":[[2019,7,17]],"date-time":"2019-07-17T05:04:46Z","timestamp":1563339886000},"page":"1013-1018","source":"Crossref","is-referenced-by-count":23,"title":["Bacterial septic arthritis infections associated with intra-articular injection practices for osteoarthritis knee pain\u2014New Jersey, 2017"],"prefix":"10.1017","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9389-1548","authenticated-orcid":false,"given":"Kathleen M.","family":"Ross","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason S.","family":"Mehr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara L.","family":"Carothers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca D.","family":"Greeley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Benowitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Henry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa A.","family":"McHugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"DiFedele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Adler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Naqvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Lifshitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara E.","family":"Montana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,7,17]]},"reference":[{"key":"S0899823X19001685_ref18","unstructured":"18. USP Compounding Compendium. General Chapter 797: Pharmaceutical Compounding. United States Pharmacopeia website. https:\/\/www.usp.org\/compounding\/general-chapter-797. Published 2015. Accessed June 3, 2019."},{"key":"S0899823X19001685_ref2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.13.1510"},{"key":"S0899823X19001685_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2016.02.033"},{"key":"S0899823X19001685_ref14","unstructured":"14. Siegel J , Rhinehart E , Jackson M , Chiarello L , Commitee HICPA. Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/niosh\/docket\/archive\/pdfs\/NIOSH-219\/0219-010107-siegel.pdf. Published 2007. 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Brusch JL. Septic arthritis. Medscape website. https:\/\/emedicine.medscape.com\/article\/236299-overview. Published 2018. Accessed June 3, 2019."},{"key":"S0899823X19001685_ref7","volume-title":"Methicillin-Susceptible Staphylococcus aureus Infections After Intra-articular Injections","author":"Archer","year":"2009"},{"key":"S0899823X19001685_ref12","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.11.5721-5732.2005"},{"key":"S0899823X19001685_ref13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1003057"},{"key":"S0899823X19001685_ref16","volume-title":"Guide to Infection Prevention for Outpatient Settings: Minimum Expectation for Safe Care","year":"2016"},{"key":"S0899823X19001685_ref19","volume-title":"APIC Text of Infection Control and Epidemiology","author":"Iwamoto","year":"2014"},{"key":"S0899823X19001685_ref21","volume-title":"Single-Dose\/Single-Use Vial Position and Messages. 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