RT Journal Article
T1 Genotypic and Phenotypic Characteristics of Staphylococcus aureus Prosthetic Joint Infections: Insight on the Pathogenesis and Prognosis of a Multicenter Prospective Cohort
A1 Munoz-Gallego, Irene
A1 Viedma, Esther
A1 Esteban, Jaime
A1 Mancheno-Losa, Mikel
A1 Garcia-Canete, Joaquin
A1 Blanco-Garcia, Antonio
A1 Rico, Alicia
A1 Garcia-Perea, Adelaida
A1 Ruiz Garbajosa, Patricia
A1 Escudero-Sanchez, Rosa
A1 Somolinos, Mar Sanchez
A1 Arriaza, Mercedes Marin
A1 Romanyk, Juan
A1 Barbero, Jose Maria
A1 Vilela, Ana Arribi
A1 Romo, Fernando Gonzalez
A1 Perez-Jorge, Conchita
A1 Arana, David M.
A1 Monereo, Alfonso
A1 Domingo, Diego
A1 Cordero, Jose
A1 Sanchez Romero, Ma Isabel
A1 Garcia Viejo, Miguel Angel
A1 Lora-Tamayo, Jaime
A1 Chaves, Fernando
A1 Grp Infeccion Osteoarticular Comun, 
K1 biofilm
K1 bone infections
K1 pathogenesis
K1 prosthetic joint infections
K1 Staphylococcus aureus
K1 Treatment failure
K1 Risk-factors
K1 Susceptibility
K1 Biofilm
K1 Device
K1 Antibiotics
K1 Rifampin
AB Background. Staphylococcus aureus is the leading cause of prosthetic joint infection (PJI). Beyond the antibiogram, little attention has been paid to the influence of deep microbiological characteristics on patient prognosis. Our aim was to investigate whether microbiological genotypic and phenotypic features have a significant influence on infection pathogenesis and patient outcome.Methods. A prospective multicenter study was performed, including all S. aureus PJIs (2016-2017). Clinical data and phenotypic (agr functionality, beta-hemolysis, biofilm formation) and genotypic characteristics of the strains were collected. Biofilm susceptibility to antimicrobials was investigated (minimal biofilm eradication concentration [MBEC] assay).Results. Eighty-eight patients (39.8% men, age 74.7 +/- 14.1 years) were included. Forty-five had early postoperative infections (EPIs), 21 had chronic infections (CPIs), and 19 had hematogenous infections (HIs). Twenty (22.7%) were caused by methicillin-resistant S. aureus. High genotypic diversity was observed, including 16 clonal complexes (CCs), with CC5 being the most frequent (30.7%). agr activity was greater in EPI than CPI (55.6% vs 28.6%; P = .041). Strains causing EPI were phenotypically and genotypically similar, regardless of symptom duration. Treatment failure (36.5%) occurred less frequently among cases treated with implant removal. In cases treated with debridement and implant retention, there were fewer failures among those who received combination therapy with rifampin. No genotypic or phenotypic characteristics predicted failure, except vancomycin minimal inhibitory concentration >= 1.5 mg/L (23.1% failure vs 3.4%; P = .044). MBEC(50 )was >128 mg/L for all antibiotics tested and showed no association with prognosis.Conclusions. S. aureus with different genotypic backgrounds is capable of causing PJI, showing slight differences in clinical presentation and pathogenesis. No major microbiological characteristics were observed to influence the outcome, including MBEC.
PB Oxford univ press inc
SN 2328-8957
YR 2020
FD 2020-09-01
LK http://hdl.handle.net/10668/18960
UL http://hdl.handle.net/10668/18960
LA en
DS RISalud
RD Mar 14, 2025