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Diagnosis of Streptococcus canis periprosthetic joint infection: the utility of next-generation sequencing

Majd Tarabichi1, Abtin Alvand1, Noam Shohat1

  • 1Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA.

Arthroplasty Today
|March 22, 2018
PubMed

Insights

A dog scratch led to a rare knee prosthesis infection by Streptococcus canis. Next-generation sequencing identified the bacteria, enabling targeted treatment and successful reimplantation surgery.

Area of Science:

  • Infectious Disease
  • Microbiology
  • Orthopedic Surgery

Background:

  • Prosthetic joint infections (PJIs) are serious complications following arthroplasty.
  • Identifying the causative organism is crucial for effective treatment, but traditional cultures can fail.

Observation:

  • A 62-year-old male with a history of knee arthroplasty presented with a PJI.
  • Initial cultures were negative, delaying diagnosis.
  • The patient reported a recent dog scratch followed by licking by his pet.

Findings:

  • Next-generation sequencing (NGS) of intraoperative samples identified Streptococcus canis as the causative agent.
  • Streptococcus canis, typically found in the oral flora of dogs, was linked to the patient's dog scratch injury.
  • Treatment was guided by the antibiotic sensitivity of the identified Streptococcus canis strain.

Implications:

  • This case highlights the utility of NGS in diagnosing PJIs when conventional methods fail.
  • It underscores the potential zoonotic transmission of bacteria like Streptococcus canis from pets to humans, even through minor injuries.
  • Prompt identification and targeted antibiotic therapy are essential for managing rare PJIs and achieving favorable outcomes, including successful reimplantation.
Keywords:
Culture negativeHip arthroplastyKnee arthroplastyNext-generation sequencingPeriprosthetic joint infection

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