Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria?
Prosthetic joint infection (PJI) is a feared and challenging to diagnose complication after arthroplasty, with Staphylococcus epidermidis as the major pathogen. One important criteria to define PJI is the detection of phenotypically indistinguishable microorganisms with identical antibiotic suscepti...
Published in: | European Journal of Clinical Microbiology & Infectious Diseases |
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Umeå universitet, Institutionen för klinisk mikrobiologi
2022
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ftumeauniv:oai:DiVA.org:umu-188180 2023-10-09T21:54:35+02:00 Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? Widerström, Micael Stegger, Marc Johansson, Anders Gurram, Bharat Kumar Larsen, Anders Rhod Wallinder, Lars Edebro, Helen Monsen, Tor 2022 application/pdf http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-188180 https://doi.org/10.1007/s10096-021-04352-w eng eng Umeå universitet, Institutionen för klinisk mikrobiologi European Journal of Clinical Microbiology and Infectious Diseases, 0934-9723, 2022, 41, s. 87-97 orcid:0000-0003-0548-5943 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-188180 doi:10.1007/s10096-021-04352-w PMID 34599708 ISI:000702789200001 Scopus 2-s2.0-85116301940 info:eu-repo/semantics/openAccess Staphylococcus epidermidis Genomics Multidrug resistant Prosthetic joint infection Within-patient variation Diagnosis Polymicrobial Infectious Medicine Infektionsmedicin Article in journal info:eu-repo/semantics/article text 2022 ftumeauniv https://doi.org/10.1007/s10096-021-04352-w 2023-09-22T13:55:58Z Prosthetic joint infection (PJI) is a feared and challenging to diagnose complication after arthroplasty, with Staphylococcus epidermidis as the major pathogen. One important criteria to define PJI is the detection of phenotypically indistinguishable microorganisms with identical antibiotic susceptibility pattern in at least two different samples. However, owing to phenotypical variation within genetic clones and clonal variation within a phenotype, the criteria may be ambiguous. We investigated the extent of diversity among coagulase-negative staphylococci (CoNS) in PJI and characterised S. epidermidis isolates from PJI samples, specifically multiple S. epidermidis isolates identified in individual PJI patients. We performed a retrospective cohort study on 62 consecutive patients with PJI caused by CoNS from two hospitals in Northern Sweden. In 16/62 (26%) PJIs, multiple S. epidermidis isolates were available for whole-genome analyses. Hospital-adapted multidrug-resistant genetic clones of S. epidermidis were identified in samples from 40/62 (65%) of the patients using a combination of pulsed-field gel electrophoresis and multilocus sequence typing. Whole-genome sequencing showed the presence of multiple sequence types (STs) in 7/16 (44%) PJIs where multiple S. epidermidis isolates were available. Within-patient phenotypical variation in the antibiotic susceptibility and/or whole-genome antibiotic resistance gene content was frequent (11/16, 69%) among isolates with the same ST. The results highlight the ambiguity of S. epidermidis phenotypic characterisation as a diagnostic method in PJI and call for larger systematic studies for determining the frequency of CoNS diversity in PJIs, the implications of such diversity for microbiological diagnostics, and the therapeutic outcomes in patients. Article in Journal/Newspaper Northern Sweden Umeå University: Publications (DiVA) European Journal of Clinical Microbiology & Infectious Diseases |
institution |
Open Polar |
collection |
Umeå University: Publications (DiVA) |
op_collection_id |
ftumeauniv |
language |
English |
topic |
Staphylococcus epidermidis Genomics Multidrug resistant Prosthetic joint infection Within-patient variation Diagnosis Polymicrobial Infectious Medicine Infektionsmedicin |
spellingShingle |
Staphylococcus epidermidis Genomics Multidrug resistant Prosthetic joint infection Within-patient variation Diagnosis Polymicrobial Infectious Medicine Infektionsmedicin Widerström, Micael Stegger, Marc Johansson, Anders Gurram, Bharat Kumar Larsen, Anders Rhod Wallinder, Lars Edebro, Helen Monsen, Tor Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? |
topic_facet |
Staphylococcus epidermidis Genomics Multidrug resistant Prosthetic joint infection Within-patient variation Diagnosis Polymicrobial Infectious Medicine Infektionsmedicin |
description |
Prosthetic joint infection (PJI) is a feared and challenging to diagnose complication after arthroplasty, with Staphylococcus epidermidis as the major pathogen. One important criteria to define PJI is the detection of phenotypically indistinguishable microorganisms with identical antibiotic susceptibility pattern in at least two different samples. However, owing to phenotypical variation within genetic clones and clonal variation within a phenotype, the criteria may be ambiguous. We investigated the extent of diversity among coagulase-negative staphylococci (CoNS) in PJI and characterised S. epidermidis isolates from PJI samples, specifically multiple S. epidermidis isolates identified in individual PJI patients. We performed a retrospective cohort study on 62 consecutive patients with PJI caused by CoNS from two hospitals in Northern Sweden. In 16/62 (26%) PJIs, multiple S. epidermidis isolates were available for whole-genome analyses. Hospital-adapted multidrug-resistant genetic clones of S. epidermidis were identified in samples from 40/62 (65%) of the patients using a combination of pulsed-field gel electrophoresis and multilocus sequence typing. Whole-genome sequencing showed the presence of multiple sequence types (STs) in 7/16 (44%) PJIs where multiple S. epidermidis isolates were available. Within-patient phenotypical variation in the antibiotic susceptibility and/or whole-genome antibiotic resistance gene content was frequent (11/16, 69%) among isolates with the same ST. The results highlight the ambiguity of S. epidermidis phenotypic characterisation as a diagnostic method in PJI and call for larger systematic studies for determining the frequency of CoNS diversity in PJIs, the implications of such diversity for microbiological diagnostics, and the therapeutic outcomes in patients. |
format |
Article in Journal/Newspaper |
author |
Widerström, Micael Stegger, Marc Johansson, Anders Gurram, Bharat Kumar Larsen, Anders Rhod Wallinder, Lars Edebro, Helen Monsen, Tor |
author_facet |
Widerström, Micael Stegger, Marc Johansson, Anders Gurram, Bharat Kumar Larsen, Anders Rhod Wallinder, Lars Edebro, Helen Monsen, Tor |
author_sort |
Widerström, Micael |
title |
Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? |
title_short |
Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? |
title_full |
Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? |
title_fullStr |
Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? |
title_full_unstemmed |
Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? |
title_sort |
heterogeneity of staphylococcus epidermidis in prosthetic joint infections : time to reevaluate microbiological criteria? |
publisher |
Umeå universitet, Institutionen för klinisk mikrobiologi |
publishDate |
2022 |
url |
http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-188180 https://doi.org/10.1007/s10096-021-04352-w |
genre |
Northern Sweden |
genre_facet |
Northern Sweden |
op_relation |
European Journal of Clinical Microbiology and Infectious Diseases, 0934-9723, 2022, 41, s. 87-97 orcid:0000-0003-0548-5943 http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-188180 doi:10.1007/s10096-021-04352-w PMID 34599708 ISI:000702789200001 Scopus 2-s2.0-85116301940 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/10.1007/s10096-021-04352-w |
container_title |
European Journal of Clinical Microbiology & Infectious Diseases |
_version_ |
1779318197785198592 |