{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:31:58Z","timestamp":1793748718029,"version":"4.6.1"},"reference-count":40,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>This study aimed to compare clinical characteristics and outcomes in patients with native joint septic arthritis (NJSA) due to methicillin-resistant Staphylococcus aureus (MRSA) in comparison to methicillin-sensitive S. aureus (MSSA) and identify treatment failure risk factors. We conducted a multi-center retrospective study on adult NJSA patients at three teaching hospitals in South Korea from 2005 to 2017. Among 101 patients diagnosed with S. aureus NJSA, 39 (38.6%) had MRSA strains. Compared to MSSA, patients with MRSA had a higher prevalence of nosocomial infections (17.9% vs. 1.6%; p = 0.005) and received inappropriate antibiotics within 48 h more frequently (74.4% vs. 0%; p &lt; 0.001). In total, twenty patients (19.8%) experienced treatment failure, which encompassed five patients (5.0%) who passed away, nine (8.9%) requiring repeated surgical drainage after 30 days of antibiotic therapy, and seven (6.9%) with relapse. The MRSA group showed a higher rate of overall treatment failure (33.3% vs. 11.3%; p = 0.007) with a notably increased frequency of requiring repeated surgical interventions after 30 days of antibiotic therapy (17.9% vs. 3.2%, p = 0.026), in contrast to the MSSA group. Independent risk factors for treatment failure included Charlson comorbidity score, elevated CRP levels, and methicillin resistance. Methicillin resistance is an independent risk factor for treatment failure, emphasizing the need for vigilant monitoring and targeted interventions in MRSA-related NJSA cases.<\/jats:p>","DOI":"10.3390\/antibiotics12111628","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T10:51:37Z","timestamp":1700045497000},"page":"1628","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Methicillin Resistance Increased the Risk of Treatment Failure in Native Joint Septic Arthritis Caused by Staphylococcus aureus"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0694-1579","authenticated-orcid":false,"given":"Jungok","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Deajeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So Yeon","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul 05355, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3237-044X","authenticated-orcid":false,"given":"Kyung Mok","family":"Sohn","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Deajeon 35015, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bomi","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Seoul 03181, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun-Jeong","family":"Joo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Seoul 03181, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/S0140-6736(09)61595-6","article-title":"Bacterial septic arthritis in adults","volume":"375","author":"Mathews","year":"2010","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.3899\/jrheum.150434","article-title":"Native Joint Septic Arthritis: Epidemiology, Clinical Features, and Microbiological Causes in a New Zealand Population","volume":"42","author":"Kennedy","year":"2015","journal-title":"J. Rheumatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"503","DOI":"10.3947\/ic.2020.52.4.503","article-title":"Clinical Characteristics and Causative Pathogens of Infective Arthritis and Risk Factors for Gram-Negative Bacterial Infections","volume":"52","author":"Lee","year":"2020","journal-title":"Infect. Chemother."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"ofaa593","DOI":"10.1093\/ofid\/ofaa593","article-title":"Risk Factors, Screening, and Treatment Challenges in Staphylococcus aureus Native Septic Arthritis","volume":"8","author":"Gobao","year":"2021","journal-title":"Open Forum Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"He, M., Arthur Vithran, D.T., Pan, L., Zeng, H., Yang, G., Lu, B., and Zhang, F. (2023). An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: A review. Front. Cell Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1193645"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/CMR.00048-19","article-title":"Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries","volume":"33","author":"Gandra","year":"2020","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1473-3099(18)30605-4","article-title":"Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: A population-level modelling analysis","volume":"19","author":"Cassini","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1002\/jhm.704","article-title":"Clinical and economic outcomes in patients with community-acquired Staphylococcus aureus pneumonia","volume":"5","author":"Taneja","year":"2010","journal-title":"J. Hosp. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Hidalgo-Tenorio, C., G\u00e1lvez, J., Mart\u00ednez-Marcos, F.J., Plata-Ciezar, A., De La Torre-Lima, J., L\u00f3pez-Cort\u00e9s, L.E., Noureddine, M., Reguera, J.M., Vinuesa, D., and Garc\u00eda, M.V. (2020). Clinical and prognostic differences between methicillin-resistant and methicillin-susceptible Staphylococcus aureus infective endocarditis. BMC Infect. Dis., 20.","DOI":"10.1186\/s12879-020-4895-1"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1128\/AAC.01157-10","article-title":"Clinical impact of antimicrobial resistance in European hospitals: Excess mortality and length of hospital stay related to methicillin-resistant Staphylococcus aureus bloodstream infections","volume":"55","author":"Wolkewitz","year":"2011","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1086\/527389","article-title":"Comparison of both clinical features and mortality risk associated with bacteremia due to community-acquired methicillin-resistant Staphylococcus aureus and methicillin-susceptible S. aureus","volume":"46","author":"Wang","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"ofx013","DOI":"10.1093\/ofid\/ofx013","article-title":"Similar Clinical Severity and Outcomes for Methicillin-Resistant and Methicillin-Susceptible Staphylococcus aureus Pediatric Musculoskeletal Infections","volume":"4","author":"An","year":"2017","journal-title":"Open Forum Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.3904\/kjim.2017.098","article-title":"Reevaluation of the impact of methicillin-resistance on outcomes in patients with Staphylococcus aureus bacteremia and endocarditis","volume":"34","author":"Joo","year":"2019","journal-title":"Korean J. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Lin, W.T., Wu, C.D., Cheng, S.C., Chiu, C.C., Tseng, C.C., Chan, H.T., Chen, P.Y., and Chao, C.M. (2015). High Prevalence of Methicillin-Resistant Staphylococcus aureus among Patients with Septic Arthritis Caused by Staphylococcus aureus. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0127150"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1093\/cid\/cis746","article-title":"A large multicenter study of methicillin-susceptible and methicillin-resistant Staphylococcus aureus prosthetic joint infections managed with implant retention","volume":"56","author":"Murillo","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1093\/rheumatology\/kei035","article-title":"Methicillin-resistant Staphylococcus aureus septic arthritis: An emerging clinical syndrome","volume":"44","author":"Ross","year":"2005","journal-title":"Rheumatology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1007\/s00402-007-0285-z","article-title":"Methicillin resistant Staphylococcus aureus versus methicillin sensitive Staphylococcus aureus adult haematogenous septic arthritis","volume":"127","author":"Bobak","year":"2007","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.reuma.2014.12.009","article-title":"Septic arthritis due to methylcyllin-resistant Staphylococcus aureus in adults","volume":"11","author":"Molinos","year":"2015","journal-title":"Reumatol. Clin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2229","DOI":"10.1001\/archinte.162.19.2229","article-title":"Outcome and attributable mortality in critically Ill patients with bacteremia involving methicillin-susceptible and methicillin-resistant Staphylococcus aureus","volume":"162","author":"Blot","year":"2002","journal-title":"Arch. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1086\/345476","article-title":"Comparison of mortality associated with methicillin-resistant and methicillin-susceptible Staphylococcus aureus bacteremia: A meta-analysis","volume":"36","author":"Cosgrove","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Li, Z., Zhuang, H., Wang, G., Wang, H., and Dong, Y. (2021). Prevalence, predictors, and mortality of bloodstream infections due to methicillin-resistant Staphylococcus aureus in patients with malignancy: Systemic review and meta-analysis. BMC Infect. Dis., 21.","DOI":"10.1186\/s12879-021-05763-y"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"558","DOI":"10.2106\/JBJS.N.00593","article-title":"Risk factors for failure of a single surgical debridement in adults with acute septic arthritis","volume":"97","author":"Hunter","year":"2015","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6547","DOI":"10.1007\/s00402-023-04958-z","article-title":"Failure rates in surgical treatment in adults with bacterial arthritis of a native joint: A systematic review of 8,586 native joints","volume":"143","author":"Walinga","year":"2023","journal-title":"Arch. Orthop. Trauma. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5194\/jbji-8-29-2023","article-title":"Guideline for management of septic arthritis in native joints (SANJO)","volume":"8","author":"Ravn","year":"2023","journal-title":"J. Bone Jt. Infect."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1007\/s10067-014-2844-3","article-title":"Predictors of treatment failure and mortality in native septic arthritis","volume":"34","author":"Maneiro","year":"2015","journal-title":"Clin. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1093\/cid\/ciz265","article-title":"Epidemiology, Management, and Outcomes of Large and Small Native Joint Septic Arthritis in Adults","volume":"70","author":"McBride","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1136\/ard-2022-222143","article-title":"Management and outcome of native joint septic arthritis: A nationwide survey in French rheumatology departments, 2016\u20132017","volume":"81","author":"Coiffier","year":"2022","journal-title":"Ann Rheum Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"8192","DOI":"10.1038\/s41598-023-35384-1","article-title":"Early postoperative laboratory parameters are predictive of initial treatment failure in acute septic arthritis of the knee and shoulder joint","volume":"13","author":"Straub","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jinf.2018.02.015","article-title":"Native septic arthritis is not an immediate surgical emergency","volume":"77","author":"Lauper","year":"2018","journal-title":"J. Infect."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s00264-012-1546-1","article-title":"Time delay between diagnosis and arthroscopic lavage in septic arthritis. Does it matter?","volume":"36","author":"Kodumuri","year":"2012","journal-title":"Int. Orthop."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.jiac.2019.06.010","article-title":"Antimicrobial resistance in South Korea: A report from the Korean global antimicrobial resistance surveillance system (Kor-GLASS) for 2017","volume":"25","author":"Liu","year":"2019","journal-title":"J. Infect. Chemother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.ajic.2014.08.014","article-title":"Antimicrobial susceptibility profiles of Staphylococcus aureus isolates classified according to their origin in a tertiary hospital in Korea","volume":"42","author":"Moon","year":"2014","journal-title":"Am. J. Infect. Control."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1016\/j.cmi.2023.05.008","article-title":"Early switch from intravenous to oral antibiotic treatment in bone and joint infections","volume":"29","author":"Sendi","year":"2023","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.ijid.2019.02.005","article-title":"Antibiotic penetration into bone and joints: An updated review","volume":"81","author":"Thabit","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1056\/NEJMoa1710926","article-title":"Oral versus Intravenous Antibiotics for Bone and Joint Infection","volume":"380","author":"Li","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"dlaa114","DOI":"10.1093\/jacamr\/dlaa114","article-title":"Treatment of methicillin-resistant Staphylococcus aureus (MRSA): Updated guidelines from the UK","volume":"3","author":"Brown","year":"2021","journal-title":"JAC Antimicrob. Resist."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.1093\/cid\/ciq146","article-title":"Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children","volume":"52","author":"Liu","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1136\/ard.35.3.198","article-title":"Review of septic arthritis throughout the antibiotic era","volume":"35","author":"Newman","year":"1976","journal-title":"Ann. Rheum. Dis."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic Dis."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/11\/1628\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:23:26Z","timestamp":1760131406000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/12\/11\/1628"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,15]]},"references-count":40,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["antibiotics12111628"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics12111628","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,15]]}}}