Table 1.
Clinical relevance of 93 cases of osteoarticular infections due to Streptococcus species
| Characteristic | Total (n = 93), n (%) | Monomicrobial infection (n = 34), n (%) | Polymicrobial infection (n = 59), n (%) |
|---|---|---|---|
| Sex | |||
| Female | 16 (17) | 6 (18) | 10 (17) |
| Male | 77 (83) | 28 (82) | 49 (83) |
| Comorbidities and risk factors | 84 (90) | 25 (74) | 59 (100) |
| Diabetes mellitus | 34 (37) | 10 (29) | 24 (41) |
| Tobacco use | 28 (30) | 10 (29) | 18 (31) |
| Peripheral arterial disease | 27 (29) | 6 (18) | 21 (36) |
| Peripheral neuropathy | 21 (23) | 1 (3) | 20 (34) |
| Malignancy | 15 (16) | 6 (18) | 9 (15) |
| Haematologic malignancy | 4 (4) | 3 (9) | 1 (2) |
| Solid cancer | 11 (12) | 3 (9) | 8 (14) |
| Chronic liver disease | 10 (11) | 1 (3) | 9 (15) |
| Immunodeficiency | 9 (10) | 5 (15) | 4 (7) |
| Corticosteroid treatment | 4 (4) | 1 (3) | 3 (5) |
| Asplenia | 2 (2) | 2 (6) | 0 |
| HIV infection | 2 (2) | 0 | 2 (3) |
| Alcoholism | 7 (8) | 0 | 7 (12) |
| Inflammatory rheumatism | 5 (5) | 2 (6) | 3 (5) |
| Pneumonia | 3 (3) | 1 (3) | 2 (3) |
| Intravenous drug users | 2 (2) | 1 (3) | 1 (2) |
| Chronic wound | 42 (45) | 1 (3) | 41 (69) |
| Closed fracture | 22 (24) | 4 (12) | 18 (31) |
| Open fracture | 8 (9) | 3 (9) | 5 (8) |
| Clinical and biological presentation | |||
| Local inflammation | 64 (69) | 22 (65) | 42 (71) |
| Purulent discharge inside wound | 57 (61) | 9 (26) | 48 (81) |
| Fever | 40 (43) | 20 (59) | 20 (34) |
| Erysipelas | 13 (14) | 2 (6) | 11 (19) |
| Bacteraemia | 13 (14) | 6 (18) | 7 (12) |
| Severe sepsis | 3 (3) | 2 (6) | 1 (2) |
| Endocarditis | 3 (3) | 3 (9) | 0 |
| C-reactive protein rate ≥40 mg/mL | 73 (79) | 28 (82) | 45 (76) |
| Type of infection | |||
| Without orthopaedic devicea | 60 (65) | 17 (50) | 46 (78) |
| Osteitis | 42 (45) | 4 (12) | 38 (64) |
| Arthritis | 12 (13) | 8 (24) | 4 (7) |
| Vertebral osteomyelitis | 9 (10) | 5 (15) | 4 (7) |
| With orthopaedic deviceb | 33 (35) | 17 (50) | 16 (27) |
| Internal osteosynthesis device infection | 17 (18) | 8 (24) | 9 (15) |
| Joint prosthesis infection | 14 (15) | 8 (24) | 6 (10) |
| Vertebral osteosynthesis device infection | 3 (3) | 1 (3) | 2 (3) |
| Infection localization | |||
| Foot | 31 (33) | 2 (6) | 29 (49) |
| Knee | 15 (16) | 9 (26) | 6 (10) |
| Tibia | 14 (15) | 6 (18) | 8 (14) |
| Vertebra | 12 (13) | 8 (24) | 4 (7) |
| Hip | 9 (10) | 5 (15) | 4 (7) |
| Ankle | 8 (9) | 4 (12) | 4 (7) |
| Hand | 4 (4) | 0 | 4 (7) |
| Wrist | 2 (2) | 2 (6) | 0 |
| Sternoclavicular | 1 (1) | 1 (3) | 0 |
| Shoulder | 1 (1) | 1 (3) | 0 |
| Femur | 1 (1) | 0 (0) | 1 (2) |
| Pelvis | 2 (2) | 1 (3) | 1 (2) |
| Multiple localization | 6 (6) | 4 (12) | 2 (3) |
| Orthopaedic device infection delays | |||
| Early infection (month 1) | 4 (12) | 1 (6) | 3 (19) |
| Delayed infection (months 2–6) | 6 (18) | 4 (24) | 2 (13) |
| Late infection (more than month 6) | 23 (70) | 12 (71) | 11 (69) |
a
Three vertebral infections without osteosynthesis were associated with osteitis and arthritis in one and two, respectively.
b
One vertebral osteosynthesis device infection was associated with osteitis with internal osteosynthesis device infection.