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Sequence types of Staphylococcus epidermidis associated with prosthetic joint infections are not present in the laminar airflow during prosthetic joint surgery
Örebro universitet, Institutionen för hälsovetenskap och medicin. Centre for Clinical Research, Uppsala University, Uppsala, Sweden; County Hospital, Västerås, Sweden.ORCID-id: 0000-0003-2867-1044
Region Örebro län. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
Örebro universitet, Institutionen för hälsovetenskap och medicin.
Örebro universitet, Institutionen för läkarutbildning.ORCID-id: 0000-0001-5939-2932
2015 (engelsk)Inngår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 123, nr 7, s. 589-595Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Molecular characterization of Staphylococcus epidermidis isolates from prosthetic joint infections (PJIs) has demonstrated a predominance of healthcare-associated multi-drug resistant sequence types (ST2 and ST215). How, and when, patients acquire these nosocomial STs is not known. The aim was to investigate if sequence types of S. epidermidis associated with PJIs are found in the air during prosthetic joint surgery. Air sampling was undertaken during 17 hip/knee arthroplasties performed in operating theaters equipped with mobile laminar airflow units in a 500-bed hospital in central Sweden. Species identification was performed using MALDI-TOF MS and 16S rRNA gene analysis. Isolates identified as S. epidermidis were further characterized by MLST and antibiotic susceptibility testing. Seven hundred and thirty-five isolates were available for species identification. Micrococcus spp. (n = 303) and coagulase-negative staphylococci (n = 217) constituted the majority of the isolates. Thirty-two isolates of S. epidermidis were found. S. epidermidis isolates demonstrated a high level of allelic diversity with 18 different sequence types, but neither ST2 nor ST215 was found. Commensals with low pathogenic potential dominated among the airborne microorganisms in the operating field during prosthetic joint surgery. Nosocomial sequence types of S. epidermidis associated with PJIs were not found, and other routes of inoculation are therefore of interest in future studies.

sted, utgiver, år, opplag, sider
Hoboken, USA: Wiley-Blackwell, 2015. Vol. 123, nr 7, s. 589-595
Emneord [en]
Staphylococcus epidermidis, ST2, ST215, prosthetic joint infections, airborne transmission
HSV kategori
Forskningsprogram
Immunologi; Mikrobiologi; Patologi
Identifikatorer
URN: urn:nbn:se:oru:diva-44704DOI: 10.1111/apm.12392ISI: 000356972400007PubMedID: 25951935Scopus ID: 2-s2.0-84932196136OAI: oai:DiVA.org:oru-44704DiVA, id: diva2:814627
Merknad

Funding Agencies:

Örebro County Council Research Committee, Örebro Sweden

Centre for Clinical Research, Västerås

County Council of Västmanland Research Fund

Tilgjengelig fra: 2015-05-27 Laget: 2015-05-27 Sist oppdatert: 2019-11-12bibliografisk kontrollert
Inngår i avhandling
1. Molecular epidemiology of Staphylococcus epidermidis in prosthetic joint infections
Åpne denne publikasjonen i ny fane eller vindu >>Molecular epidemiology of Staphylococcus epidermidis in prosthetic joint infections
2019 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Staphylococcus epidermidis is ubiquitous in the human microbiota, but also an important pathogen in healthcare-associated infections, such as prosthetic joint infections (PJIs). In this thesis, aspects of the molecular epidemiology of S. epidermidis in PJIs were investigated with the aim of improving our understanding of the pre- and perioperative measures required to reduce the incidence of S. epidermidis PJIs.

In Paper I, S. epidermidis retrieved from air sampling in the operating field during arthroplasty was characterized by multilocus sequence typing and antibiotic susceptibility testing. No isolates belonging to sequence types (STs) 2 and 215, previously associated with PJIs, were found in the air of the operating field. During air sampling, several Staphylococcus pettenkoferi isolates were identified, and as a spin-off of Paper I, the genomic relatedness of these isolates to S. pettenkoferi isolates from blood cultures was described in Paper II.

In Paper III, genetic traits distinguishing S. epidermidis isolated from PJIs were determined using genome-wide association study accounting for population effects after whole-genome sequencing (WGS) of a population- based 10-year collection of S. epidermidis isolates from PJIs and of nasal isolates retrieved from patients scheduled for arthroplasty. Genes associated with antimicrobial agents used for prophylaxis in arthroplasty, i.e., beta-lactam antibiotics, aminoglycosides, and chlorhexidine, were associated with PJI origin. S. epidermidis from PJIs were dominated by the ST2a, ST2b, ST5, and ST215 lineages.

In Paper IV, selective agar plates were used to investigate colonization with methicillin resistant S. epidermidis (MRSE) in patients scheduled for arthroplasty. MRSE were further characterized by WGS. A subset of patients was found to harbour PJI-associated S. epidermidis lineages in their microbiota before hospitalization, but no isolates belonging to the ST2a lineage nor any rifampicin-resistant isolates were retrieved.

sted, utgiver, år, opplag, sider
Örebro: Örebro University, 2019. s. 137
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 203
Emneord
Staphylococcus epidermidis, molecular epidemiology, prosthetic joint infections, whole genome sequencing, Staphylococcus pettenkoferi
HSV kategori
Identifikatorer
urn:nbn:se:oru:diva-76142 (URN)978-91-7529-309-7 (ISBN)
Disputas
2019-12-06, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2019-09-06 Laget: 2019-09-06 Sist oppdatert: 2019-11-12bibliografisk kontrollert

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