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URL: http://rjms.iums.ac.ir/article-1-2809-en.html
Background: Determining
the etiologic agents of septic arthritis is very important. The aim of the
present study was to determine group A streptococcal polysaccharide antigens in
synovial fluid of patients with arthritis.
Methods: A cross
sectional study was conducted upon 52 cases with acute mono arthritis in
Hazrat-e-Rasool Akram hospital in Tehran, Iran (2010-2012).Gram staining,
culture and rapid antigen tests were performed (LPA) for H. influenza, S.
pneumonia, group B streptococci, N. meningitidis, E.coli and Group A
streptococcal polysaccharide antigens (Cusabio
company Austria liscence, China, ELISA) was searched in synovial samples
(negative smear and culture). p value <0.05 was considered valuable.
Results: Septic arthitis was diagnosed in 34.5% that
included positive culture or gram staining in 15%, positive rapid antigen test
(LPA) in 5.7%, positive group A streptococcal polysaccharide antigens in 3.8%
of cases with negative results for other tests.
Conclusions: Septic arthitis
was diagnosed in 34.6% of cases. Only 15% of
cases had positive culture or gram stain (mainly S. aureus, S. pneumonis), 5.7%
were diagnosed by rapid antigenic tests (LPA) and group A streptococcal
polysaccharide antigens (ELISA) test was positive in 3.8% of the remaining cases
(negative smear and culture). By addingthenew diagnostic methods to the
conventional culture tests for detecting common bacterial antigens (especially
streptococcus), the role of infectious organisms in evolution of acute arthitis
would be elucidated better. Streptococcal polysaccharide antigens in synovial
fluid are not defined by the immune system. The irreversible cardiac, renal, and
neurologic complications are probable. Optimal treatment of proved
streptococcal cases is recommended.
