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Corynebacterium striatum Prosthetic Joint Infection Successfully Treated with Long-Term Dalbavancin
Örebro University, School of Medical Sciences.ORCID iD: 0000-0001-5939-2932
Department of Orthopedics, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Bacteria, Parasites and Fungi, Statens Serum Institut, 2300 Copenhagen, Denmark.ORCID iD: 0000-0003-0321-1180
2023 (English)In: Microorganisms, E-ISSN 2076-2607, Vol. 11, no 3, article id 550Article in journal (Refereed) Published
Abstract [en]

Arthroplasty surgery is a common procedure that significantly improves quality of life. The most feared complication is prosthetic joint infection (PJI), which occurs more often following revision surgery. Staphylococci are the most prevalent bacteria in PJIs, although many other pathogens have been reported. We describe a case of PJI in a 75-year-old farmer following revision surgery caused by Corynebacterium striatum, an unusual agent which normally occurs in the normal human skin microbiota with perceived low pathogenicity. Following a cemented right-sided total hip arthroplasty in 2006, a one-stage revision due to an osteolytic process in the right femur took place in 2020 with negative intraoperative tissue cultures. Three weeks later, the patient presented a fulminant infection which was treated with debridement, antibiotics, and implant retention (DAIR). Tissue biopsies showed C. striatum in 6/6 samples including small colony variants. Genome sequencing showed that all isolates differed by ≤6 SNPs with the same gene content related to resistance (tet(W) and erm(X)). The patient was sequentially treated with vancomycin, linezolid, and daptomycin, but due to side effects, treatment was changed to 12 weeks of dalbavancin as a 1000 mg loading dose followed by 500 mg intravenously/week. Impaired renal function during vancomycin treatment was normalized, and >1 year after finishing antibiotic treatment the outcome was still favourable. In conclusion, a case of a fulminant early post-interventional PJI due to C. striatum was successfully treated with DAIR and long-term dalbavancin therapy without any adverse reactions.

Place, publisher, year, edition, pages
MDPI, 2023. Vol. 11, no 3, article id 550
Keywords [en]
Corynebacterium striatum, genome sequencing, prosthetic joint infection
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-105222DOI: 10.3390/microorganisms11030550ISI: 000959136900001PubMedID: 36985124Scopus ID: 2-s2.0-85151360213OAI: oai:DiVA.org:oru-105222DiVA, id: diva2:1747554
Available from: 2023-03-30 Created: 2023-03-30 Last updated: 2023-04-21Bibliographically approved

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Söderquist, BoStegger, Marc

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