{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:03:54Z","timestamp":1775016234092,"version":"3.50.1"},"reference-count":34,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,12,6]]},"abstract":"<jats:p>Septic arthritis is a medical emergency, and if not treated appropriately, it can be associated with high morbidity and mortality. Melioidosis, a serious infectious disease caused by the Gram-negative bacillus <jats:italic>Burkholderia pseudomallei<\/jats:italic>, is highly endemic in South and Southeast Asia and northern Australia. We reviewed the medical charts of adult patients admitted with bacterial septic arthritis at Sunpasitthiprasong Hospital, Ubon Ratchathani, northeast Thailand from January 2012 to December 2014. Bacterial septic arthritis was defined as one or more hot swollen joints with isolation of a pathogenic organism from an affected joint or from blood. A total of 154 patients with septic arthritis were retrospectively evaluated. The most common causes were <jats:italic>B. pseudomallei<\/jats:italic> (48%, <jats:italic>N<\/jats:italic> = 74), <jats:italic>Streptococcus<\/jats:italic> spp. (29%, <jats:italic>N<\/jats:italic> = 44), and <jats:italic>Staphylococcus aureus<\/jats:italic> (10%, <jats:italic>N<\/jats:italic> = 16). Prevalence of diabetes, bacteremia, and pneumonia was higher in <jats:italic>B. pseudomallei<\/jats:italic> septic arthritis than in septic arthritis caused by the other bacteria (all <jats:italic>P<\/jats:italic> &lt; 0.01). Seventy three percent (54\/74) of patients infected with <jats:italic>B. pseudomallei<\/jats:italic> and 69% (55\/80) of patients with the other bacteria received effective antimicrobials on the first day of admission (<jats:italic>P<\/jats:italic> = 0.60), but in-hospital mortality of the former group was considerably higher (34% versus 14%, <jats:italic>P<\/jats:italic> = 0.004). In conclusion, <jats:italic>B. pseudomallei<\/jats:italic> septic arthritis is common and associated with high mortality in northeast Thailand. Emergence of <jats:italic>Streptococcus<\/jats:italic> arthritis is observed. Difficulty in diagnosing melioidosis and identifying <jats:italic>B. pseudomallei<\/jats:italic> in areas where health care workers are not familiar with the disease is discussed. In melioidosis-endemic regions, parenteral ceftazidime could be considered as empirical antimicrobial therapy for patients with septic arthritis and underlying diseases.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0288","type":"journal-article","created":{"date-parts":[[2017,10,3]],"date-time":"2017-10-03T07:00:49Z","timestamp":1507014049000},"page":"1695-1701","source":"Crossref","is-referenced-by-count":19,"title":["Clinical Epidemiology of Septic Arthritis Caused by Burkholderia pseudomallei and Other Bacterial Pathogens in Northeast Thailand"],"prefix":"10.4269","volume":"97","author":[{"given":"Prapit","family":"Teparrukkul","sequence":"first","affiliation":[{"name":"Medical department, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiraphorn","family":"Nilsakul","sequence":"additional","affiliation":[{"name":"Microbiological department, Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Dunachie","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom;"},{"name":"Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Direk","family":"Limmathurotsakul","sequence":"additional","affiliation":[{"name":"Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom;"},{"name":"Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;"},{"name":"Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"846","article-title":"Bacterial septic arthritis in adults","volume":"375","author":"Mathews","year":"2010"},{"key":"b2","series-title":"Lancet","first-page":"197","article-title":"Septic arthritis","volume":"351","author":"Goldenberg","year":"1998"},{"key":"b3","series-title":"Epidemiol Infect","first-page":"423","article-title":"An 18 year clinical review of septic arthritis from tropical Australia","volume":"117","author":"Morgan","year":"1996"},{"key":"b4","series-title":"Br J Rheumatol","first-page":"333","article-title":"HIV infection as a risk factor for septic arthritis","volume":"36","author":"Saraux","year":"1997"},{"key":"b5","series-title":"Clin Rheumatol","first-page":"S59","article-title":"Melioidosis\u2014an unusual cause of septic arthritis","volume":"27","author":"Thomas","year":"2008"},{"key":"b6","series-title":"Trop Doct","first-page":"164","article-title":"A rare cause of septic arthritis: melioidosis","volume":"43","author":"Caldera","year":"2013"},{"key":"b7","series-title":"Emerg Infect Dis","first-page":"e2","article-title":"Workshop on treatment of and postexposure prophylaxis for Burkholderia pseudomallei and B. mallei infection, 2010","volume":"18","author":"Lipsitz","year":"2012"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e900","article-title":"The epidemiology and clinical spectrum of melioidosis: 540 cases from the 20 year Darwin prospective study","volume":"4","author":"Currie","year":"2010"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"1113","article-title":"Increasing incidence of human melioidosis in northeast Thailand","volume":"82","author":"Limmathurotsakul","year":"2010"},{"key":"b10","series-title":"Nat Microbiol","first-page":"15008","article-title":"Predicted global distribution of Burkholderia pseudomallei and burden of melioidosis","volume":"1","author":"Limmathurosakul","year":"2016"},{"key":"b11","series-title":"Trop Med Int Health","first-page":"1167","article-title":"Melioidosis epidemiology and risk factors from a prospective whole-population study in northern Australia","volume":"9","author":"Currie","year":"2004"},{"key":"b12","series-title":"Clin Microbiol Rev","first-page":"527","article-title":"Acute septic arthritis","volume":"15","author":"Shirtliff","year":"2002"},{"key":"b13","series-title":"J Clin Rheumatol","first-page":"74","article-title":"Streptococcus agalactiae: an emerging cause of septic arthritis","volume":"20","author":"Louthrenoo","year":"2014"},{"key":"b14","series-title":"PLoS One","first-page":"e31265","article-title":"Population-based study of Streptococcus suis infection in humans in Phayao Province in northern Thailand","volume":"7","author":"Takeuchi","year":"2012"},{"key":"b15","series-title":"Pathology","first-page":"53","article-title":"Multicentre study of the in vitro activity of cefepime, a broad-spectrum cephalosporin, compared to other broad-spectrum agents","volume":"33","author":"Bell","year":"2001"},{"key":"b16","series-title":"PLoS One","first-page":"e4308","article-title":"Staphylococcus aureus bacteraemia in a tropical setting: patient outcome and impact of antibiotic resistance","volume":"4","author":"Nickerson","year":"2009"},{"key":"b17","series-title":"PLoS One","first-page":"e54714","article-title":"Epidemiology, microbiology and mortality associated with community-acquired bacteremia in northeast Thailand: a multicenter surveillance study","volume":"8","author":"Kanoksil","year":"2013"},{"key":"b18","series-title":"Southeast Asian J Trop Med Public Health","first-page":"649","article-title":"Rheumatological manifestations in patients with melioidosis","volume":"39","author":"Teparrakkul","year":"2008"},{"key":"b19","series-title":"Emerg Infect Dis","first-page":"740","article-title":"Increased neurotropic threat from Burkholderia pseudomallei strains with a B. mallei-like variation in the bimA motility gene, Australia","volume":"23","author":"Morris","year":"2017"},{"key":"b20","series-title":"PLoS One","first-page":"e91682","article-title":"Variable virulence factors in Burkholderia pseudomallei (melioidosis) associated with human disease","volume":"9","author":"Sarovich","year":"2014"},{"key":"b21","series-title":"Indian J Orthop","first-page":"216","article-title":"Burkholderia pseudomallei musculoskeletal infections (melioidosis) in India","volume":"44","author":"Pandey","year":"2010"},{"key":"b22","series-title":"N Engl J Med","first-page":"1035","article-title":"Melioidosis","volume":"367","author":"Wiersinga","year":"2012"},{"key":"b23","series-title":"Ann Rheum Dis","first-page":"470","article-title":"Incidence and sources of native and prosthetic joint infection: a community based prospective survey","volume":"56","author":"Kaandorp","year":"1997"},{"key":"b24","series-title":"Clin Infect Dis","first-page":"408","article-title":"Risk factors for melioidosis and bacteremic melioidosis","volume":"29","author":"Suputtamongkol","year":"1999"},{"key":"b25","series-title":"J Microbiol Immunol Infect","first-page":"527","article-title":"Clinical manifestations and bacteriological features of culture-proven Gram-negative bacterial arthritis","volume":"50","author":"Lin","year":"2017"},{"key":"b26","series-title":"BMC Infect Dis","first-page":"239","article-title":"Morbimortality in adult patients with septic arthritis: a three-year hospital-based study","volume":"16","author":"Ferrand","year":"2016"},{"key":"b27","series-title":"J Clin Rheumatol","first-page":"242","article-title":"Septic arthritis caused by Burkholderia pseudomallei: case report and review of the literature","volume":"7","author":"Wooten","year":"2001"},{"key":"b28","series-title":"Emerg Infect Dis","first-page":"1","article-title":"Melioidosis diagnostic workshop, 2013","volume":"21","author":"Hoffmaster","year":"2015"},{"key":"b29","series-title":"J Clin Microbiol","first-page":"980","article-title":"Burkholderia pseudomallei: challenges for the clinical microbiology laboratory-a response from the front line","volume":"55","author":"Dance","year":"2017"},{"key":"b30","series-title":"Clin Microbiol Rev","first-page":"383","article-title":"Melioidosis: epidemiology, pathophysiology, and management","volume":"18","author":"Cheng","year":"2005"},{"key":"b31","series-title":"J Orthop","first-page":"86","article-title":"Osteomyelitis and septic arthritis from infection with Burkholderia pseudomallei: a 20-year prospective melioidosis study from northern Australia","volume":"10","author":"Morse","year":"2013"},{"key":"b32","series-title":"J Bone Joint Surg Am","first-page":"1058","article-title":"Melioidotic septic arthritis and its risk factors","volume":"85-A","author":"Kosuwon","year":"2003"},{"key":"b33","series-title":"PLoS Negl Trop 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