Bacteriological and serological study on synovial Fluid in septic arthritis patients

Background
Septic arthritis is the   microbial infection of the   joint constituents. Various microorganisms can be involved in arthritis like bacteria, viruses, fungi and other microorganisms like Mycoplasma. bacterial pathogens are the most significant.
Aims of the study:
1- To study the most important macroscopic and microscopic characters of synovial fluid samples in patients with septic arthritis.
2-Iisolation and identification of bacteria involved in septic arthritis.
3- To perform some serological tests for patients with septic arthritis, like (CRP, ASOT, RF).
4- To study of white blood cell count, sugar and protein in synovial fluid of patients with septic arthritis.
Materials & Methods:
One hundred patients from both sexes and different age groups (1-80) years  were included   in this study. They were attending Department of Orthopedics and Joints Diseases in Ramadi GeneralHospital and Private Clinics of Orthopedics and Joints diseases during the period from May 2008 to January 2009. synovial fluid aspirates and blood specimens were taken from each one , these specimens were manipulated soon following bacteriological ,serological  and biochemical required tests.
Results:  
Twenty five (25) patients were suffering from septic arthritis and seventy five (75) of them were affected with aseptic type, males represented 67% of total patients.
The highest rate of arthritis was found within age group (19-49) years old while septic arthritis was higher within Age group (50-80) years old patients.  Synovial fluid from 22 patients showed poor mucin while that from 23 patients had low viscosity and 10 patients showed purulent synovial fluid. Gram positive bacteria were most common pathogens, regarding single infections Staphylococcus aureus  took the first rank of isolation (11 isolates) with (55%) followed by Staphylococcus epidermidis and Escherichia coli. Other bacteria were showing lower rate of isolation. patients with septic arthritis were showing more WBCs in their synovial fluid. The mean values of C- reactive protein within age groups (19-49) and (50-80) years of septic arthritis were 26 mg/L and 27 mg/L respectively. (17) patients with aseptic arthritis and one patient of septic arthritis showed positive rheumatoid factor test.
One child and another one patient within the same age group (19-49) years old were showed positive titer of ASOT test.
Mean sugar values in synovial fluid of septic type were lower than that of a septic type while all patients were showing higher protein values in synovial fluid.