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Finegoldia magna Isolated from Orthopedic Joint Implant-Associated Infections
Bo Söderquist1,2, Sanna Björklund3, Bengt Hellmark3,2
1School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden bo.soderquist@oru.se.
Abstract:
The anaerobic Gram-positive coccus Finegoldia magna is a rare cause of infections of bone and joints. The aim of this study was to describe the microbiological and clinical characteristics of orthopedic implant-associated infections caused by F. magna We retrospectively analyzed samples consisting of anaerobic Gram-positive cocci and samples already identified as F. magna from patients with orthopedic infections. The isolates found were determined to the species level using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The antibiotic susceptibility pattern was determined by Etest. Whole-genome sequencing (WGS) was performed. Clinical data were extracted from each patient's journal. In nine patients, orthopedic joint implant-associated infections were identified as being caused by F. magna The isolates were susceptible to most of the antibiotics tested, with the exception of rifampin and moxifloxacin in a few cases. Five of the nine infections were monomicrobial. The most common antibiotic used to treat the infection was penicillin V, but five of the nine patients received a combination of antibiotics. Eight patients underwent surgical treatment, with extraction of the implant performed in seven cases and reimplantation in only two cases. The WGS showed a relatively small core genome, with 126,647 single nucleotide polymorphisms identified within the core genome. A phylogenomic analysis revealed that the isolates clustered into two distinct clades. Orthopedic implant-associated infections caused by F. magna are rare, but the bacteria are generally susceptible to antibiotics. Despite this, surgical treatment combined with long-term antibiotics is often necessary. The WGS analysis revealed a high heterogeneity and suggested the existence of at least two different Finegoldia species.
Insights
Finegoldia magna causes rare bone and joint infections. While generally antibiotic-susceptible, treatment often requires surgery and long-term antibiotics, with genomic analysis revealing distinct bacterial clades.
Area of Science:
- Microbiology
- Infectious Diseases
- Genomics
Background:
- Finegoldia magna, an anaerobic Gram-positive coccus, is an infrequent cause of bone and joint infections.
- Orthopedic implant-associated infections present unique challenges in diagnosis and treatment.
Purpose of the Study:
- To characterize the microbiological and clinical features of orthopedic implant-associated infections caused by F. magna.
- To investigate the antibiotic susceptibility and genomic diversity of F. magna isolates from these infections.
Main Methods:
- Retrospective analysis of patient samples and clinical data.
- Identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS).
- Antibiotic susceptibility testing (Etest) and whole-genome sequencing (WGS).
Main Results:
- Nine cases of F. magna orthopedic implant-associated infections were identified.
- Isolates were mostly susceptible to antibiotics, except for rare resistance to rifampin and moxifloxacin.
- Five infections were monomicrobial; treatment often involved penicillin V, combination antibiotics, and surgical intervention (implant removal in 7/8 patients).
- WGS revealed significant genomic heterogeneity, with phylogenomic analysis suggesting at least two distinct F. magna clades.
Conclusions:
- F. magna orthopedic implant infections are rare but require aggressive management.
- Despite general antibiotic susceptibility, surgical intervention is frequently necessary.
- Genomic data indicate potential cryptic speciation within F. magna, impacting understanding of its pathogenicity.
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