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In Vivo Mouse Model of Spinal Implant Infection
Published on: June 23, 2020
A spinal infection with Staphylococcus pseudintermedius
Christopher A Darlow1, Nikolaos Paidakakos2, Murtuza Sikander2
1Department of Infectious Diseases and Microbiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Abstract:
We present a case of a 60-year-old woman with an invasive spinal infection with Staphylococcus pseudintermedius associated with a 15-year-old spinal fixation device and epidemiological contact with dogs. It was confirmed on blood culture and culture from pus from the epidural abscess and successfully treated using similar treatment as for a Staphylococcus aureus infection 6 weeks of intravenous flucloxacillin 2 g four times daily with a 6 week follow-on course of oral clindamycin 450 mg three times daily. This case represents the first reported deep abscess forming infection with this recently discovered organism. This case highlights that (1) S. pseudintermedius has a potential for invasive zoonotic infection, (2) treatment as for S. aureus appears adequate for resolution of the case, (3) the increased use of the matrix-assisted laser desorption/ionisation time-of-flight identification technique is leading to more specific identification of previously unrecognised organisms.
Insights
This case report details a rare invasive spinal infection caused by Staphylococcus pseudintermedius, a bacterium typically found in animals. Prompt treatment, similar to Staphylococcus aureus infections, led to successful recovery.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Case Report
Background:
- Spinal infections can be severe and challenging to treat.
- Staphylococcus pseudintermedius is an emerging pathogen with zoonotic potential.
- The identification of microorganisms is crucial for effective treatment.
Observation:
- A 60-year-old woman presented with an invasive spinal infection linked to a long-standing spinal fixation device and contact with dogs.
- Blood and epidural abscess pus cultures confirmed Staphylococcus pseudintermedius.
- The patient developed a deep abscess, a previously unreported presentation for this organism.
Findings:
- The infection was successfully treated with a regimen of intravenous flucloxacillin followed by oral clindamycin, mirroring treatment protocols for Staphylococcus aureus infections.
- Matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) technology facilitated the specific identification of Staphylococcus pseudintermedius.
- This case is the first reported instance of a deep abscess caused by Staphylococcus pseudintermedius.
Implications:
- Staphylococcus pseudintermedius poses a zoonotic risk and can cause invasive infections in humans.
- Standard treatment protocols for Staphylococcus aureus infections appear effective against Staphylococcus pseudintermedius.
- Advances in microbial identification techniques are revealing previously unrecognized pathogens and their clinical significance.
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