Septic arthritis due to Neisseria gonorrhoea in Western Australia

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Abstract

Objective
To investigate the frequency, risk factors and long‐term outcome of gonococcal arthritis in Western Australia (WA).
Methods
A population‐based data linkage study of patients with a hospital‐based diagnosis of gonococcal arthritis (GA) in WA between 1990‐2014. Demographics, standardised incidence rates (IR) per million and comorbidity accrued before (lookback 186 months ,IQR 86‐267) and after the index hospital contact for GA (follow‐up 100 months, IQR 60‐209). are presented as frequency (%), median (interquartile range) or rates /1,000 months.
Results
In total 98 patients were diagnosed with GA. The annual incidence of GA increased from 1.35 to 2.10 per million between 1990 and 2014, but the rate of GA complicating all gonococcal infections was stable around 0.25%. Female patients with GA (54%, n=53/98) were younger (24 vs 38 years), and more frequently identified as Indigenous (88% vs 49%) than male patients (46%, n=45/98) (p=0.002). Female patients had higher rates of prior infections (15.5 vs 8.1 per 1,000 months, p=0.002) and diabetes mellitus (15.9% vs 2.5%, p=0.03) and a longer hospital stay (10 vs 8 days, p=0.02). GA recurrence rate during follow‐up was low (2%), but a broad range of comorbidities developed contributing to a 14% crude death rate.
Conclusions
GA stably complicates 0.25% of gonococcal infections in WA with young Indigenous females and middle‐aged non‐Indigenous males most affected. Prior infectious disease and diabetes mellitus are potential risk factors for GA in females. GA recurs rarely, but its development reflects a high risk of morbidity and mortality over the following ten years.
Original languageEnglish
JournalInternal Medicine Journal (Print)
DOIs
Publication statusE-pub ahead of print - 2021

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