Abstract
Staphylococcus aureus is a commensal colonizing the skin and mucous membranes. It can also act as a pathogen, and is the most common microorganism isolated from prosthetic joint infections (PJIs). The aim of this study was to explore the genomic relatedness between commensal and PJI S. aureus strains as well as microbial traits and host-related risk factors for treatment failure. Whole-genome sequencing (WGS) was performed on S. aureus isolates obtained from PJIs (n = 100) and control isolates from nares (n = 101). Corresponding clinical data for the PJI patients were extracted from medical records. No PJI-specific clusters were found in the WGS phylogeny, and the distribution of the various clonal complexes and prevalence of virulence genes among isolates from PJIs and nares was almost equal. Isolates from patients with treatment success and failure were genetically very similar, while the presence of an antibiotic-resistant phenotype and the use of non-biofilm-active antimicrobial treatment were both associated with failure.In conclusion, commensal and PJI isolates of S. aureus in arthroplasty patients were genetically indistinguishable, suggesting that commensal S. aureus clones are capable of causing PJIs. Furthermore, no association between genetic traits and outcome could be demonstrated, stressing the importance of patient-related factors in the treatment of S. aureus PJIs.
Highlights
Staphylococcus aureus is a commensal colonizing the skin and mucous membranes
Nineteen different clonal complexes (CCs) were found among the prosthetic joint infections (PJIs) isolates and 24 different CCs among the nasal isolates
Using whole-genome data, the present study investigated associations between genotypic and phenotypic characteristics and microbiological eradication of infection and success of treatment in PJIs
Summary
Staphylococcus aureus is a commensal colonizing the skin and mucous membranes It can act as a pathogen, and is the most common microorganism isolated from prosthetic joint infections (PJIs). The aim of this study was to explore the genomic relatedness between commensal and PJI S. aureus strains as well as microbial traits and host-related risk factors for treatment failure. The aims of the present study were to characterize a cohort of patients with PJIs caused by S. aureus, and to compare the genomes of the corresponding isolates with those of nasal commensals to explore possible associations between microbial traits and outcome of treatment of infection
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