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  • 1.
    Wildeman, Peter
    et al.
    Örebro University, School of Medical Sciences. Department of Orthopedics, Örebro University Hospital, Örebro, Sweden.
    Brüggemann, Holger
    Department of Biomedicine, Aarhus University, Aarhus, Denmark.
    Scholz, Christian F. P.
    Department of Biomedicine, Aarhus University, Aarhus, Denmark.
    Leimbach, Andreas
    Institute of Hygiene, University of Münster, Münster, Germany.
    Söderquist, Bo
    Örebro University, School of Medical Sciences.
    Propionibacterium avidum as an Etiological Agent of Prosthetic Hip Joint Infection2016In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 6, article id e0158164Article in journal (Refereed)
    Abstract [en]

    Propionibacterium acnes is well-established as a possible etiologic agent of prosthetic joint infections (PJIs). Other Propionibacterium spp. have occasionally been described as a cause of PJIs, but this has not previously been the case for P. avidum despite its capacity to form biofilm. We describe two patients with prosthetic hip joint infections caused by P. avidum. Both patients were primarily operated with an anteriorly curved skin incision close to the skin crease of the groin, and both were obese. Initial treatment was performed according to the DAIR procedure (debridement, antibiotics, and implant retention). In case 1, the outcome was successful, but in case 2, a loosening of the cup was present 18 months post debridement. The P. avidum isolate from case 1 and two isolates from case 2 (obtained 18 months apart) were selected for whole genome sequencing. The genome of P. avidum obtained from case 1 was approximately 60 kb larger than the genomes of the two isolates of case 2. These latter isolates were clonal with the exception of SNPs in the genome. All three strains possessed the gene cluster encoding exopolysaccharide synthesis.

    P. avidum has a pathogenic potential and the ability to cause clinically relevant infections, including abscess formation, in the presence of foreign bodies such as prosthetic joint components. Skin incision in close proximity to the groin or deep skin crease, such as the anteriorly curved skin incision approach, might pose a risk of PJIs by P. avidum, especially in obese patients.

  • 2.
    Wildeman, Peter
    et al.
    Örebro University, School of Medical Sciences. Department of Orthopedics.
    Tevell, Staffan
    Örebro University, School of Medical Sciences. Department of Infectious Diseases, Karlstad, and Centre for Clinical Research, Region Värmland, Karlstad, Sweden.
    Eriksson, Carl
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Campillay Lagos, Amaya
    Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Söderquist, Bo
    Örebro University, School of Medical Sciences. Department of Laboratory Medicine.
    Stenmark, Bianca
    Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Laboratory Medicine.
    Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureusManuscript (preprint) (Other academic)
  • 3.
    Wildeman, Peter
    et al.
    Örebro University, School of Medical Sciences. Department of Orthopedics.
    Tevell, Staffan
    Örebro University, School of Medical Sciences. Department of Infectious Diseases, Karlstad, and Centre for Clinical Research, Region Värmland, Karlstad, Sweden..
    Eriksson, Carl
    Örebro University, School of Medical Sciences. Örebro University Hospital.
    Lagos, Amaya Campillay
    Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Söderquist, Bo
    Örebro University, School of Medical Sciences. Department of Laboratory Medicine.
    Stenmark, Bianca
    Örebro University, School of Medical Sciences.
    Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureus2020In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 10, no 1, article id 5938Article in journal (Refereed)
    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.

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