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Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureus
Örebro University, School of Medical Sciences. Department of Orthopedics.
Örebro University, School of Medical Sciences. Department of Infectious Diseases, Karlstad, and Centre for Clinical Research, Region Värmland, Karlstad, Sweden..ORCID iD: 0000-0002-9213-9274
Örebro University, School of Medical Sciences. Örebro University Hospital.ORCID iD: 0000-0002-1046-383x
Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
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2020 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 5938Article in journal (Refereed) Published
Abstract [en]

Staphylococcus aureus is a commensal colonizing the skin and mucous membranes. It can also act as a pathogen, and is the most common microorganism isolated from prosthetic joint infections (PJIs). The aim of this study was to explore the genomic relatedness between commensal and PJI S. aureus strains as well as microbial traits and host-related risk factors for treatment failure. Whole-genome sequencing (WGS) was performed on S. aureus isolates obtained from PJIs (n = 100) and control isolates from nares (n = 101). Corresponding clinical data for the PJI patients were extracted from medical records. No PJI-specific clusters were found in the WGS phylogeny, and the distribution of the various clonal complexes and prevalence of virulence genes among isolates from PJIs and nares was almost equal. Isolates from patients with treatment success and failure were genetically very similar, while the presence of an antibiotic-resistant phenotype and the use of non-biofilm-active antimicrobial treatment were both associated with failure.In conclusion, commensal and PJI isolates of S. aureus in arthroplasty patients were genetically indistinguishable, suggesting that commensal S. aureus clones are capable of causing PJIs. Furthermore, no association between genetic traits and outcome could be demonstrated, stressing the importance of patient-related factors in the treatment of S. aureus PJIs.

Place, publisher, year, edition, pages
Nature Publishing Group, 2020. Vol. 10, no 1, article id 5938
National Category
Infectious Medicine Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-81038DOI: 10.1038/s41598-020-62751-zISI: 000563494300002PubMedID: 32246045Scopus ID: 2-s2.0-85083042211OAI: oai:DiVA.org:oru-81038DiVA, id: diva2:1421861
Note

Funding Agencies:

Research Committee of Orebro University, Region Örebro County, Örebro, Sweden  OLL735561

Centre for Clinical Research, Region Värmland, Karlstad, Sweden  LIVFOU-842521 LIVFOU-741321

Örebro University 

Available from: 2020-04-06 Created: 2020-04-06 Last updated: 2023-08-29Bibliographically approved
In thesis
1. Prosthetic Joint Infection of the Hip: Cause and Effect
Open this publication in new window or tab >>Prosthetic Joint Infection of the Hip: Cause and Effect
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Every year, 18 000 patients in Sweden and more than 1 million worldwide undergo total hip arthroplasty (THA). The operation is of great benefit to patients, but is associated with several complications. Prosthetic joint infections (PJIs) are among the most common complications, and can be devastating in terms of suffering for the patient and cost for the healthcare provider. The aim of this thesis was to investigate different aspects of PJIs in order to gain a better understanding of the causes and effects of infection. 

Four studies were conducted covering genomic analysis of the causative organism, identification of risk factors for failure of treatment, evaluation of a national infection control program aimed at reducing the burden of infections (PRISS: Prosthesis-related infections shall be stopped), and examination of the long-term impact of a PJI on the patient’s health through patient-reported measurement questionnaires.

The main findings were as follows. Commensal bacteria such as Cutibacterium avidum have the potential to cause PJIs, and should be specially accounted for when performing hip surgery with an anterior approach. S. aureus is both a commensal and a pathogen with invasive capacity, and the commensal strains do not differ from the PJI strains regarding prevalence of virulence genes and clonal complexes. The genomic traits of pathogens had no impact on treatment success or eradication of infection in S. aureus PJIs The long-term effects of a PJI in the hip include increased mortality, lower quality of life, and decreased hip function. The incidence of PJIs was higher following the PRISS project. Increasing risk factors contributing to PJI explain the increasing incidence of PJI after primary THA.

In conclusion, PJIs of the hip have multifactorial causes which are difficult to reduce, and long-term effects are severe.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2021. p. 98
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 246
Keywords
Prosthetic joint infection, infection, arthroplasty, hip, Staphylococcus aureus, Cutibacterium avidum, hip, outcome, PROM
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-92269 (URN)978-91-7529-398-1 (ISBN)
Public defence
2021-10-01, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
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Supervisors
Available from: 2021-06-09 Created: 2021-06-09 Last updated: 2023-08-29Bibliographically approved

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Wildeman, PeterTevell, StaffanEriksson, CarlSöderquist, BoStenmark, Bianca

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