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A large proportion of reported cases of infection had a history of water exposure, 58% from swimming or diving, 16% from bathing, 10% from water sports such as jet skiing, water-skiing and wakeboarding and 9% from nasal irrigation

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In the synovial fluid of individuals with OA, increased lactate facilitates lactylation of UDP-glucose dehydrogenase (UGDH) at lysine 6, disrupting its interaction with signal transducer and activator of transcription 1 (STAT1), suppressing its enzymatic activity and glycosaminoglycan synthesis, and altering its nuclear-cytoplasmic distribution, activating the MAPK signaling pathway and ultimately contributing to OA progression

University of Arizona Press, 1985