Medical Clinic and Policlinic I, University Hospital Dresden, Dresden, Germany.
Eur J Clin Microbiol Infect Dis. 2010 Apr;29(4):457-63. doi: 10.1007/s10096-010-0884-4. Epub 2010 Feb 26.
The objective of the study was to determine if a clonal complex (CC) of Staphylococcus aureus or certain virulence and adhesion factors were associated with infections of bones and prosthetic implants. One hundred and nineteen isolates were characterised using microarrays. There was no evidence for a single virulence factor or CC being causative for bone and implant infections. Isolates belonged to 20 different CCs, with CC8 (19.33%), CC45 (17.65%) and CC30 (12.61%) being dominant. Population structure and the relative abundances of virulence genes was similar to previously described isolates from healthy carriers. Differences to carrier isolates included a higher proportion of CC45, a lower proportion of CC15, as well as a higher abundance of sak (staphylokinase) among patient isolates. For 23 patients with infections of total knee or hip prosthetics, it was possible to simultaneously obtain nasal swabs. Fifteen (65.2%) carried S. aureus in their anterior nares. In nine of them (39.1%), isolates from the infection site were identical to carriage isolates. This suggests an elevated risk of infection for S. aureus carriers and the possibility of endogenous infection in a high proportion of them. Therefore, the pre-operative screening and eradication of S. aureus in patients receiving total joint prosthetics should be considered.
本研究旨在确定金黄色葡萄球菌的克隆复合体（CC）或某些毒力和黏附因子是否与骨和假体植入物感染有关。使用微阵列对 119 株分离株进行了特征描述。没有证据表明单一毒力因子或 CC 是导致骨和植入物感染的原因。分离株属于 20 个不同的 CC，其中 CC8（19.33%）、CC45（17.65%）和 CC30（12.61%）占优势。种群结构和毒力基因的相对丰度与先前描述的健康携带者中的分离株相似。与携带者分离株的差异包括 CC45 的比例较高，CC15 的比例较低，以及患者分离株中 sak（链激酶）的丰度较高。对于 23 名接受全膝关节或髋关节假体感染的患者，可以同时获得鼻拭子。15 名（65.2%）在前鼻道携带金黄色葡萄球菌。其中 9 名（39.1%）患者感染部位的分离株与携带分离株相同。这表明金黄色葡萄球菌携带者感染的风险增加，并且他们中有很大一部分可能存在内源性感染。因此，应考虑对接受全关节假体的患者进行术前筛查和金黄色葡萄球菌的根除。
