2023年尼尔基础科学奖:Cutibacterium acnes的遗传学在修订肩膀关节整形术中:一项大规模的细菌全基因组测序研究
Jason E Hsu1, Frederick A Matsen1, Anastasia J Whitson1
1Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA.
Journal of shoulder and elbow surgery
|April 11, 2024
概括
导致肩围假肢关节感染 (PJI) 的Cutibacterium acnes通常起源于患者自己的皮肤. 遗传分析显示,PJI菌株与皮肤菌株相似,慢性感染缺乏关键细菌基因.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 杆菌 (C. acnes) 是造成肩围假肢关节感染 (PJI) 的主要原因.
- 确定肩膀PJI中的C. acnes的起源 (内源或外源) 是有效治疗的关键.
- 鉴定与PJI发展相关的C. acnes遗传因素是一个关键的研究领域.
研究的目的:
- 为了确定肩膀PJI中的C. acnes是否来自患者内生菌群或外生来源.
- 为了确定C. acnes与肩膀PJI.病变发生相关的特定遗传特征.
- 为了将C. acnes菌株的分子流行病学和遗传含量与临床感染特征相关联.
主要方法:
- 从88名接受肩膀关节整形手术的患者中341个C. acnes分离物的全基因组测序.
- 从一个单一机构的存储库中在四年内收集的单独样本的分析.
- 分子流行病学和遗传数据与临床PJI特征的相关性.
主要成果:
- 来自肩部PJI手术标本的C. acnes与患者的皮肤殖民菌株具有显著的遗传相似性 (P < .001).
- 菌株的跨患者传播不常见,这表明内源来源占主导地位.
- 慢性PJI病例与C. acnes.中缺乏定数感应基因 (luxS,tqsA) 相关.
结论:
- 患者自身的皮肤C. acnes菌株是肩膀关节整形手术感染的主要来源.
- 虽然一些C. acnes类型表现出适度增加的毒性,但所有这些类型都具有PJI的致病潜力.
- 这些发现凸显了对内源性细菌的外科手术期脱殖战略的研究的需要.
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