Septic Arthritis Outbreak in NJ Linked to Intra-articular Injections

HealthDay News — In a report published in the US Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, details are presented of an outbreak of septic arthritis associated with intra-articular injections at a New Jersey outpatient practice.

Kathleen Ross, MPH, from the New Jersey Department of Health (NJDOH), and colleagues describe an outbreak of septic arthritis associated with intra-articular injections at an outpatient practice in New Jersey. On March 6, 2017, the NJDOH was notified of 3 cases of septic arthritis in patients who had received intra-articular injections for osteoarthritic knee pain.

The authors note that the NJDOH, together with the local health department and the New Jersey Board of Medical Examinations, identified 41 cases of septic arthritis associated with intra-articular injections administered during 250 patient visits at the same practice. 

Thirty of these cases were patients who required surgery. Bacterial cultures of synovial fluid or tissue were positive for 37% of patients; all recovered organisms were oral flora. Multiple breaches of recommended infection prevention practices were identified in an infection prevention assessment, including inadequate hand hygiene, inappropriate use of pharmacy bulk packaged (PBP) products as multiple-dose containers, handling of PBP products outside required pharmacy conditions, and syringe preparation up to 4 days before their intended use.

“The findings from this investigation highlight the need for better adherence to and oversight of basic infection prevention recommendations and sterile compounding standards in outpatient settings,” the authors write.

Reference

Ross K, Mehr J, Carothers, B et al. Outbreak of septic arthritis associated with intra-articular injections at an outpatient practice- New Jersey, 2017. MMWR Morb Mortal Wkly Rep. 2017;66(29):777-779.