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[山羊葡萄球菌所致全髋关节置换术后感染。病例报告及文献复习]

[Infection after total hip replacement by Staphylococcus caprae. Case report and review of the literature].

作者信息

Blanc V, Picaud J, Legros E, Bes M, Etienne J, Moatti D, Raynaud M F

机构信息

Laboratoire, Centre Hospitalier d'Antibes Juan-les-Pins, Antibes, France.

出版信息

Pathol Biol (Paris). 1999 May;47(5):409-13.

Abstract

We report a case of Staphylococcus caprae bone and joint infection, that illustrate difficulties to diagnose coagulase-negative staphylococci (CNS) orthopedic surgery infections, specially following implantation of prostheses. Four of 5 strains successivelly isolated from deep and/or peri-operative specimens during late infection after total hip replacement (THR) have been identified, using commercial systems and conventionnal tests, as S. caprae. Identity of biochemical profile, antibiotype and pulsotype of the 4 isolates confirmed the pathogenicity of this animal CNS, rarely described as a human pathogen. Analysis of the 24 S. caprae human cases previously described evidence a relation ship between this bacteria and bone and joint infections, with implantation of prosthetic material as supplementary risk factor. S. caprae, whose major identification criteria are resumed, may have previously been misidentified as some similar CNS; this bacteria is probably part of our normal flora but may be recognized as an opportunistic pathogen, responsible for both nosocomial and community acquired infections.

摘要

我们报告了1例山羊葡萄球菌骨与关节感染病例,该病例说明了凝固酶阴性葡萄球菌(CNS)骨科手术感染的诊断困难,尤其是在假体植入后。在全髋关节置换术(THR)术后晚期感染期间,从深部和/或围手术期标本中相继分离出的5株菌株中,有4株经商业系统和传统试验鉴定为山羊葡萄球菌。4株分离株的生化谱、抗菌型和脉冲型特征确认了这种通常被视为动物病原菌的微生物作为人类病原体的致病性,此前很少将其描述为人类病原体。对先前描述的24例山羊葡萄球菌感染人类病例的分析表明,这种细菌与骨和关节感染之间存在关联,假体材料植入是额外的危险因素。山羊葡萄球菌的主要鉴定标准总结如下,它之前可能被误鉴定为一些相似的CNS;这种细菌可能是我们正常菌群的一部分,但可能被认为是一种机会性病原体,可导致医院感染和社区获得性感染。

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