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Same Organism, Different Phenotype: Are Phenotypic Criteria Adequate In Coagulase-Negative Staphylococcal Orthopaedic Implant-Associated Infections?
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Infectious Diseases, Karlstad, and Centre for Clinical Research, County Council of Värmland, Sweden.
Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Department of Infectious Diseases and Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.
Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark.
Visa övriga samt affilieringar
2019 (Engelska)Ingår i: Journal of bone and joint infection, ISSN 2206-3552, Vol. 4, nr 1, s. 16-19Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

In current diagnostic criteria for implant-associated bone- and joint infections, phenotypically identical low-virulence bacteria in two intraoperative cultures are usually required. Using whole-genome sequencing, we have further characterized three phenotypically different Staphylococcus capitis isolated from one prosthetic joint infection, highlighting the challenges in defining microbiological criteria for low-virulence prosthetic joint infections.

Ort, förlag, år, upplaga, sidor
British Editorial Society of Bone and Joint Surger , 2019. Vol. 4, nr 1, s. 16-19
Nationell ämneskategori
Infektionsmedicin
Identifikatorer
URN: urn:nbn:se:oru:diva-77484DOI: 10.7150/jbji.30256PubMedID: 30755843OAI: oai:DiVA.org:oru-77484DiVA, id: diva2:1362781
Tillgänglig från: 2019-10-21 Skapad: 2019-10-21 Senast uppdaterad: 2019-10-21Bibliografiskt granskad
Ingår i avhandling
1. Staphylococcal prosthetic joint infections: similar, but still different
Öppna denna publikation i ny flik eller fönster >>Staphylococcal prosthetic joint infections: similar, but still different
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Staphylococci constitute a major part of our commensal flora but are also the most common bacteria causing prosthetic joint infections (PJIs), a dreaded complication of arthroplasty surgery. However, not all staphylococci are the same. The virulent Staphylococcus aureus has the ability to cause severe disease such as bacteremia and infective endocarditis in previously healthy people, while the coagulase-negative staphylococci Staphylococcus epidermidis and Staphylococcus capitis rarely act as pathogens unless the patient is immunocompromised or has an implanted medical device, such as a prosthetic joint. This thesis accordingly explores similarities and differences between these three staphylococci in PJIs.

S. capitis can cause early postinterventional and chronic PJIs, a finding that has not previously been described. Furthermore, its nosocomial NRCS-A outbreak sublineage, recently observed in neonatal intensive care units, is also present in adult PJIs. When comparing nasal and PJI isolates, the patterns differed between staphylococcal species. In S. capitis, the commensal and infecting strains were separated phylogenetically, while they clustered together for S. aureus. This may indicate diverse reservoirs and acquisition routes in PJIs caused by different staphylococcal species.

Outcomes in early postinterventional PJIs were similar in S. capitis and S. aureus infections, with 70–80% achieving clinical cure. In S. aureus infections, no virulence genes were significantly associated with outcome. Although multidrug resistance (MDR) was rare in S. aureus, inability to use biofilm-active antibiotics was a risk factor for failure. However, in S. epidermidis and in the NRCS-A sublineage of S. capitis, MDR and glycopeptide heteroresistance were widespread, highlighting the challenge of antibiotic resistance in the treatment of PJIs.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro University, 2019. s. 114
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 200
Nyckelord
Prosthetic joint infections, staphylococcal infections, nasal carriage, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus capitis, NRCS-A, antibiotic resistance, heterogeneous glycopeptide resistance, whole-genome sequencing
Nationell ämneskategori
Allmänmedicin Infektionsmedicin
Forskningsämne
Infektionssjukdomar
Identifikatorer
urn:nbn:se:oru:diva-75928 (URN)978-91-7529-305-9 (ISBN)
Disputation
2019-11-15, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 10:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2019-08-28 Skapad: 2019-08-28 Senast uppdaterad: 2019-10-22Bibliografiskt granskad

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Tevell, StaffanSöderquist, Bo

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