Safety Practice Violations ID'd in Septic Arthritis Outbreak

Breaches of recommended infection prevention practices have been identified in an outbreak of septic arthritis cases after intra-articular injections performed in a private outpatient facility, according to a report published online in Infection Control & Hospital Epidemiology.

Following reports of three patients who developed septic arthritis after receiving intra-articular injections for osteoarthritis knee pain at the same private outpatient facility, Kathleen M. Ross, M.P.H., from the New Jersey Department of Health in Trenton, and colleagues conducted an infection prevention assessment of the implicated facility's practices. To identify patients treated at the facility who developed septic arthritis after intra-articular injections, a call was disseminated to health care providers in New Jersey.

The researchers identified 41 patients with intra-articular injection-associated septic arthritis. Of these 41 case patients, cultures of synovial fluid or tissue from 14 (37 percent) recovered bacteria consistent with oral flora. Multiple breaches of recommended infection prevention practices were identified in the infection prevention assessment, including inadequate hygiene, unsafe injection practices, and poor cleaning and disinfection practices. After infection prevention recommendations were implemented by the facility, no additional cases were identified.

"Outpatient settings sometimes fail to provide the infrastructure and resources needed to support infection prevention activities, and often lack regulatory oversight," the authors write. "This large, costly outbreak highlights the serious consequences that can occur when health care providers do not follow infection prevention recommendations."

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