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Genomic characterization and outcome of prosthetic joint infections caused by Staphylococcus aureus

Peter Wildeman1,2, Staffan Tevell3,4, Carl Eriksson3

  • 1Department of Orthopedics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden. peter.wildeman@regionorebrolan.se.

Scientific Reports
|April 5, 2020
PubMed

Insights

Commensal Staphylococcus aureus strains are genetically identical to those causing prosthetic joint infections (PJIs). Treatment failure in PJIs is linked to antibiotic resistance and non-biofilm-active therapies, not specific bacterial clones.

Area of Science:

  • Microbiology
  • Genomics
  • Infectious Diseases

Background:

  • Staphylococcus aureus is a common colonizer of skin and mucous membranes.
  • It is the leading cause of prosthetic joint infections (PJIs).
  • Understanding the genetic relationship between commensal and pathogenic S. aureus is crucial for PJI treatment.

Purpose of the Study:

  • To investigate the genomic relatedness between commensal and PJI S. aureus isolates.
  • To identify microbial traits and host factors associated with PJI treatment failure.
  • To determine if specific S. aureus clones are linked to PJI development or treatment outcomes.

Main Methods:

  • Whole-genome sequencing (WGS) of 100 S. aureus isolates from PJIs and 101 control isolates from nares.
  • Analysis of clonal complexes and virulence gene prevalence.
  • Extraction and analysis of clinical data from PJI patients, including treatment outcomes.

Main Results:

  • No distinct PJI-specific clusters were identified in the WGS phylogeny.
  • The distribution of clonal complexes and virulence genes was similar between PJI and nasal isolates.
  • Isolates from patients with treatment success and failure were genetically similar.
  • Antibiotic resistance and non-biofilm-active antimicrobial treatment were associated with treatment failure.

Conclusions:

  • Commensal and PJI S. aureus isolates from arthroplasty patients are genetically indistinguishable.
  • Commensal S. aureus clones can cause PJIs.
  • Patient-related factors, rather than bacterial genetic traits, are critical for S. aureus PJI treatment success.

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