Investigation and Management of a Small Outbreak of Septic Knee Arthritis Following Knee Arthroscopy by <i>Stenotrophomonas maltophilia</i>
Bibliographic record
Abstract
Knee septic arthritis caused by Stenotrophomonas maltophilia (S. maltophilia) was very rare in immunocompetent group but was observed in a series of post-arthroscopy patients in our hospital. This study aimed to report the clinical course and treatments of the infections and the investigation of the incidents. One patient who underwent knee arthroscopy exhibited serious knee septic arthritis 17 days postoperatively. Later, three more similar patients were also suspected of knee infection. Investigation was initiated by interviews with personnel and reviews of medical records. All instruments associated with arthroscopy were subsequently sampled and tested. While no abnormalities were revealed in medical personnel and records, positive culture of S. maltophilia was found on one arthroscope, used in all four infected patients. No violations were found in sterilization processes. The contaminated arthroscope was proven loss of airtightness subsequently. For infection treatment, double or triple therapy of levofloxacin, sulfamethoxazole-trimethoprim, and minocycline was administered, with additional debridement performed in one patient. By retrospective survey, another three patients were suspected of infection out of the total 19 patients who underwent knee arthroscopy in last 4 weeks. After intervention, all involved patients recovered. Although S. maltophilia is a rare cause of knee septic arthritis, it can still occur and even lead to nosocomial outbreaks through instrument-related transmission. Sulfamethoxazole-trimethoprim, levofloxacin, and minocycline remain the treatment of choice, despite the rising global resistance rates. Although hydrogen peroxide gas plasma sterilization serves as a fast and effective method for instrument sterilization in arthroscopy, maintaining good arthroscope condition and airtightness ensures success, which warrants periodic checks.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".