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Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureus
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Orthopedics.
Örebro universitet, Institutionen för medicinska vetenskaper. Department of Infectious Diseases, Karlstad, and Centre for Clinical Research, Region Värmland, Karlstad, Sweden.
Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.ORCID-id: 0000-0002-1046-383x
Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Vise andre og tillknytning
(engelsk)Manuskript (preprint) (Annet vitenskapelig)
HSV kategori
Identifikatorer
URN: urn:nbn:se:oru:diva-77473OAI: oai:DiVA.org:oru-77473DiVA, id: diva2:1362587
Tilgjengelig fra: 2019-10-21 Laget: 2019-10-21 Sist oppdatert: 2019-10-21bibliografisk kontrollert
Inngår i avhandling
1. Staphylococcal prosthetic joint infections: similar, but still different
Åpne denne publikasjonen i ny fane eller vindu >>Staphylococcal prosthetic joint infections: similar, but still different
2019 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
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.

sted, utgiver, år, opplag, sider
Örebro: Örebro University, 2019. s. 114
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 200
Emneord
Prosthetic joint infections, staphylococcal infections, nasal carriage, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus capitis, NRCS-A, antibiotic resistance, heterogeneous glycopeptide resistance, whole-genome sequencing
HSV kategori
Forskningsprogram
Infektionssjukdomar
Identifikatorer
urn:nbn:se:oru:diva-75928 (URN)978-91-7529-305-9 (ISBN)
Disputas
2019-11-15, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 10:00 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2019-08-28 Laget: 2019-08-28 Sist oppdatert: 2019-10-22bibliografisk kontrollert

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