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Staphylococcus argenteus as an etiological agent of prosthetic hip joint infection: a case presentation

Bo Söderquist1, Peter Wildeman1,2, Bianca Stenmark1

  • 1Department of Laboratory Medicine, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.

Journal of Bone and Joint Infection
|July 17, 2020
PubMed

Insights

Prosthetic hip infections can be caused by Staphylococcus argenteus, a pathogen often overlooked in prosthetic joint infections (PJIs). This case highlights the need to treat S. argenteus PJIs similarly to Staphylococcus aureus PJIs.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genomics

Background:

  • Prosthetic joint infections (PJIs) are a significant complication following joint replacement surgery.
  • Staphylococcus aureus is a common cause of PJIs, but other staphylococcal species may also be implicated.
  • Staphylococcus argenteus is an emerging pathogen that has been identified in various infections, but its role in PJIs is less understood.

Purpose of the Study:

  • To report a case of prosthetic hip infection caused by Staphylococcus argenteus.
  • To characterize the isolate using whole-genome sequencing.
  • To discuss the clinical implications and treatment strategies for S. argenteus-associated PJIs.

Main Methods:

  • Case presentation of a patient with prosthetic hip infection.
  • Isolation and identification of the causative pathogen.
  • Whole-genome sequencing (WGS) of the Staphylococcus argenteus isolate.
  • Antimicrobial susceptibility testing.
  • Bioinformatic analysis of WGS data to determine sequence type (ST) and identify virulence factors and resistance genes.

Main Results:

  • The prosthetic hip infection was caused by Staphylococcus argenteus.
  • Whole-genome sequencing identified the isolate as ST2250, belonging to the largest clonal complex (CC2250) of S. argenteus.
  • The isolate was phenotypically susceptible to all tested antibiotics, and WGS did not reveal any antimicrobial resistance genes.
  • Despite appropriate initial management including debridement and biofilm-active antibiotics, the patient experienced infection recurrence, necessitating suppressive antibiotic therapy.

Conclusions:

  • Staphylococcus argenteus is a potential cause of prosthetic joint infections that may be overlooked.
  • The ST2250 strain of S. argenteus may be associated with invasive infections.
  • Even in susceptible isolates, S. argenteus PJIs can be challenging to treat, with a risk of recurrence.
  • PJIs caused by Staphylococcus argenteus should be managed with the same consideration as those caused by Staphylococcus aureus, given the potential for similar virulence traits.
Keywords:
Staphylococcus argenteusantimicrobial agentsgenome analysisprosthetic joint infections

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