P-95. Predictors of bloodstream infection and its impact on mortality in septic arthritis: A 15-year review

Abstract Background Septic arthritis is often complicated by bloodstream infection (BSI), which can lead to metastatin infections and sepsis. In this study, we aimed to identify risk factors for septic arthritis-related BSI and assess its impact on clinical outcomes.Table 1.Comparison of clinical characteristics of septic arthritis patients with and without bloodstream infection. Methods A retrospective review spanning 15 years (January 2009 to May 2023) was conducted on patients diagnosed with septic arthritis. Data from patients with positive synovial fluid cultures were analyzed.Table 2.Laboratory and microbiologic findings of patients with septic arthritis according to bloodstream infections. Results Among 456 patients with septic arthritis, 16.8% (n=77) developed BSI. The 90-day mortality rate was significantly higher in patients with BSI compared with those without BSI (14.3% vs. 5.3%, P=0.004). Staphylococcus aureus was the most commonly identified organism in synovial fluid cultures and was associated with an increased risk of BSI (adjusted odds ratio [aOR], 2.20; 95% confidence interval [CI], 1.15-4.34; P=0.019). Independent risk factors for BSI included higher Sequential Organ Failure Assessment (SOFA) score (aOR, 1.23; 95% CI, 1.06–1.44; P=0.009), lymphopenia (aOR, 2.84; 95% CI, 1.38–6.15; P=0.006), and elevated C-reactive protein (CRP, mg/dL) levels (aOR, 1.07; 95% CI, 1.05–1.10; P< 0.001). Age ≥70 years (aOR, 3.96; 95% CI, 1.49–11.85; P=0.009) and higher SOFA score (aOR, 1.36; 95% CI, 1.12–1.67; P=0.002) were significant predictors of 90-day mortality, although BSI itself was not.Table 3.Multivariable analysis of risk factors for bloodstream infection and 90-day mortality in patients with septic arthritis.Variables with a P-value <0.05 in the univariable analysis were included in the multivariable analysis. Conclusion Mortality in patients with septic arthritis was primarily associated with systemic sepsis resulting from BSI rather than the BSI itself. Understanding the relationship between septic arthritis-related BSI and clinical outcomes can aid physicians in managing systemic infections and improving patient care.Figure 1.Distribution of causative organisms of septic arthritis. Disclosures All Authors: No reported disclosures