An unusual case of Erysipelothrix rhusiopathiae prosthetic joint infection from the Canadian Arctic: whole genome sequencing unable to identify a zoonotic source

• Published in: BMC Infectious Diseases
• Main Authors: Michael Groeschel, Taya Forde, Shannon Turvey, A. Mark Joffe, Catherine Hui, Prenilla Naidu, Fabien Mavrot, Susan Kutz, Ameeta E. Singh
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2019
• Subjects: Erysipelothrix rhusiopathiae; Prosthetic joint infection; Septic arthritis; Whole genome sequencing; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12879-019-3913-7; https://doaj.org/article/33cb3e302c4e4e4f91be1fa3d9b43a11

Abstract Background Erysipelothrix rhusiopathiae is a zoonotic pathogen that causes erysipeloid and is most frequently associated with exposure to domestic swine. Infection of native and prosthetic joints is a rarely reported manifestation. Case presentation We describe a case of E. rhusiopathiae prosthetic joint infection in a woman with a history of exposure to wild animals in the Canadian Arctic. Patient management involved a 1-stage surgical revision exchange with an antibiotic impregnated cement spacer and 6 weeks of intravenous penicillin G followed by 6 weeks of oral amoxicillin. Ten previously reported cases of E. rhusiopathiae joint infection are reviewed. Recent increases in mortality due to infection with this organism among host animal populations in the Canadian Arctic have generated concern regarding a potential increase in human infections. However, whole genome sequencing (WGS) of the organism was unable to identify a zoonotic origin for this case. Conclusions Consideration should be given to E. rhusiopathiae as a cause of joint infections if the appropriate epidemiologic and host risk factors exist. Expanded use of WGS in other potential animal hosts and environmental sources may provide important epidemiologic information in determining the source of human infections.