An investigation into an outbreak of septic arthritis at an outpatient facility in New Jersey identified multiple breaches of recommended infection prevention practices.

The results of the investigation were published in Infection Control & Hospital Epidemiology (ICHE), the journal for the Society for Healthcare Epidemiology of America (SHEA).

As the ICHE article — "Bacterial septic arthritis infections associated with intra-articular injection practices for osteoarthritis knee pain—New Jersey, 2017" — notes, the N.J. Department of Health received reports of multiple patients who developed septic arthritis following intra-articular injections for osteoarthritis knee pain provided at the same private outpatient facility.

An infection prevention assessment of the facility's practices found 41 patients with septic arthritis associated with intra-articular injections and identified "multiple breaches of recommended infection prevention practices, including inadequate hand hygiene, unsafe injection practices and poor cleaning and disinfection practices."

A SHEA news release notes that of the 41 patients identified, 33 required surgical removal of damaged tissue.

The outbreak was costly, with the release noting that for just 31 affected Medicare patients, charges claimed for treatment surpassed $5 million.

The outpatient facility, which voluntarily stopped performing procedures following the initial septic arthritis reports as well as complaints, was advised by state officials to follow recommendations in the Centers for Disease Control and Prevention’s 2016 Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. It was also recommended that the facility work with an infection prevention consultant on improvements. No additional cases were identified after infection prevention recommendations were implemented.