Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen?
Background. Staphylococcus aureus is one of the most common pathogens causing periprosthetic joint infection (PJI). Despite the high genetic diversity of S. aureus strains, determining phylogenetic relationships and, consequently, the source of infection is a challenging task that can only be addres...
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| Language: | Russian |
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Vreden Russian Research Institute of Traumatology and Orthopedics
2025-06-01
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| Series: | Travmatologiâ i Ortopediâ Rossii |
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| Online Access: | https://journal.rniito.org/jour/article/viewFile/17610/pdf |
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| author | Andrey A. Kechin Victoria S. Borobova Taalaibek U. Sheraliev Svetlana O. Chretien Irina N. Tromenshleger Vitaliy V. Pavlov Maxim L. Filipenko |
| author_facet | Andrey A. Kechin Victoria S. Borobova Taalaibek U. Sheraliev Svetlana O. Chretien Irina N. Tromenshleger Vitaliy V. Pavlov Maxim L. Filipenko |
| author_sort | Andrey A. Kechin |
| collection | DOAJ |
| description | Background. Staphylococcus aureus is one of the most common pathogens causing periprosthetic joint infection (PJI). Despite the high genetic diversity of S. aureus strains, determining phylogenetic relationships and, consequently, the source of infection is a challenging task that can only be addressed through detailed comparison of the genomes of the obtained isolates.
The aim of the study was to assess the feasibility of differentiating the cases of nosocomial periprosthetic joint infections, using whole-genome sequencing to identify genetic and phenotypic differences between isolates with the prospect of the application of evidence-based treatment strategies.
Methods. Genomes of 20 S. aureus isolates from 13 patients with PJI were sequenced. Standard microbiological tests and in silico analysis of genomes using ResFinder, KmerFinder, spaTyper, and SCCmecFinder programs were employed.
Results. Phylogenetic analysis was performed using core genome reconstruction and identified potential cases of nosocomial infections, as well as cases of recurrent infections. The relatedness of isolates collected between 2012 and 2019 was demonstrated, along with the evolution of their genomes, including the acquisition and loss of antibiotic resistance genes. In one case of recurrent infection, the loss of several genes was observed over a remission period of approximately 5 years. Comparison of phenotypic testing results using the disk diffusion method and resistance predictions based on genome analysis revealed discrepancies for three isolates containing the aac(6’)-aph(2’’) gene, which were resistant to tobramycin and gentamicin but susceptible to amikacin. Based on the treatment outcomes of several recurrent PJI cases, it was hypothesized that radical treatment might be more effective in cases of infections caused by multidrug-resistant nosocomial strains.
Conclusions. Whole-genome sequencing enables the identification of phylogenetically related isolates, with shared genetic and phenotypic properties confirming their relatedness. Against the backdrop of high-dose antibiotic therapy, S. aureus genomes accumulate changes that, through molecular genetic testing, may help to justify the choice of radical treatment strategy for periprosthetic joint infection, such as prosthesis removal. |
| format | Article |
| id | doaj-art-e1f2c5da180945e08ec5005ee2b5952c |
| institution | Kabale University |
| issn | 2311-2905 2542-0933 |
| language | Russian |
| publishDate | 2025-06-01 |
| publisher | Vreden Russian Research Institute of Traumatology and Orthopedics |
| record_format | Article |
| series | Travmatologiâ i Ortopediâ Rossii |
| spelling | doaj-art-e1f2c5da180945e08ec5005ee2b5952c2025-08-20T03:30:53ZrusVreden Russian Research Institute of Traumatology and OrthopedicsTravmatologiâ i Ortopediâ Rossii2311-29052542-09332025-06-01312183210.17816/2311-2905-176101397Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen?Andrey A. Kechin0https://orcid.org/0000-0002-4822-0251Victoria S. Borobova1https://orcid.org/0000-0002-4443-3997Taalaibek U. Sheraliev2https://orcid.org/0000-0002-7261-2730Svetlana O. Chretien3https://orcid.org/0000-0003-0074-8062Irina N. Tromenshleger4https://orcid.org/0009-0006-9543-3547Vitaliy V. Pavlov5https://orcid.org/0000-0002-8997-7330Maxim L. Filipenko6https://orcid.org/0000-0002-8950-5368Institute of Chemical Biology and Fundamental Medicine of Siberian Branch of the Russian Academy of ScienceInstitute of Chemical Biology and Fundamental Medicine of Siberian Branch of the Russian Academy of ScienceTsivyan Novosibirsk Research Institute of Traumatology and OrthopedicsTsivyan Novosibirsk Research Institute of Traumatology and OrthopedicsInstitute of Chemical Biology and Fundamental Medicine of Siberian Branch of the Russian Academy of ScienceTsivyan Novosibirsk Research Institute of Traumatology and OrthopedicsInstitute of Chemical Biology and Fundamental Medicine of Siberian Branch of the Russian Academy of ScienceBackground. Staphylococcus aureus is one of the most common pathogens causing periprosthetic joint infection (PJI). Despite the high genetic diversity of S. aureus strains, determining phylogenetic relationships and, consequently, the source of infection is a challenging task that can only be addressed through detailed comparison of the genomes of the obtained isolates. The aim of the study was to assess the feasibility of differentiating the cases of nosocomial periprosthetic joint infections, using whole-genome sequencing to identify genetic and phenotypic differences between isolates with the prospect of the application of evidence-based treatment strategies. Methods. Genomes of 20 S. aureus isolates from 13 patients with PJI were sequenced. Standard microbiological tests and in silico analysis of genomes using ResFinder, KmerFinder, spaTyper, and SCCmecFinder programs were employed. Results. Phylogenetic analysis was performed using core genome reconstruction and identified potential cases of nosocomial infections, as well as cases of recurrent infections. The relatedness of isolates collected between 2012 and 2019 was demonstrated, along with the evolution of their genomes, including the acquisition and loss of antibiotic resistance genes. In one case of recurrent infection, the loss of several genes was observed over a remission period of approximately 5 years. Comparison of phenotypic testing results using the disk diffusion method and resistance predictions based on genome analysis revealed discrepancies for three isolates containing the aac(6’)-aph(2’’) gene, which were resistant to tobramycin and gentamicin but susceptible to amikacin. Based on the treatment outcomes of several recurrent PJI cases, it was hypothesized that radical treatment might be more effective in cases of infections caused by multidrug-resistant nosocomial strains. Conclusions. Whole-genome sequencing enables the identification of phylogenetically related isolates, with shared genetic and phenotypic properties confirming their relatedness. Against the backdrop of high-dose antibiotic therapy, S. aureus genomes accumulate changes that, through molecular genetic testing, may help to justify the choice of radical treatment strategy for periprosthetic joint infection, such as prosthesis removal.https://journal.rniito.org/jour/article/viewFile/17610/pdfstaphylococcus aureusperiprosthetic joint infectionnosocomial infectionwhole-genome sequencingphylogenetic analysiscore genome |
| spellingShingle | Andrey A. Kechin Victoria S. Borobova Taalaibek U. Sheraliev Svetlana O. Chretien Irina N. Tromenshleger Vitaliy V. Pavlov Maxim L. Filipenko Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen? Travmatologiâ i Ortopediâ Rossii staphylococcus aureus periprosthetic joint infection nosocomial infection whole-genome sequencing phylogenetic analysis core genome |
| title | Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen? |
| title_full | Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen? |
| title_fullStr | Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen? |
| title_full_unstemmed | Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen? |
| title_short | Recurrent Cases of Periprosthetic Joint Infection Caused by Staphylococcus Aureus: Reinfection or Reactivation of a Pathogen? |
| title_sort | recurrent cases of periprosthetic joint infection caused by staphylococcus aureus reinfection or reactivation of a pathogen |
| topic | staphylococcus aureus periprosthetic joint infection nosocomial infection whole-genome sequencing phylogenetic analysis core genome |
| url | https://journal.rniito.org/jour/article/viewFile/17610/pdf |
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