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Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

Staphylococcus caprae bone and joint infections: a re-emerging infection?


PMID 24975594

Abstract

Staphylococcus caprae has been recently classified as a human pathogen, but the incidence of S.xa0caprae in human bone and joint infections (BJIs) is under-reported. In this study, we report 25 cases of S.xa0caprae BJI, and we review the 31 cases published in the literature. Molecular techniques and matrix-assisted laser desorption ionization time-of-flight mass spectrometry improved the identification of clinically relevant S.xa0caprae strains. In this study, 96% of S.xa0caprae BJIs were localized to the lower limbs, and 88% of the cases involved orthopaedic device infections. S.xa0caprae joint prosthesis infections (JPIs), internal osteosynthesis device infections (I-ODIs) and BJIs without orthopaedic device infections were recorded in 60%, 28% and 12% of cases, respectively. Ten (40%) S.xa0caprae BJIs were polymicrobial infections. These infections were associated with past histories of malignancy (pxa00.024). Of the 14 bacterial species related to S.xa0caprae BJI, 57% were staphylococci. I-ODIs were significantly associated with polymicrobial infections (pxa00.0068), unlike JPIs, which were monomicrobial infections (pxa00.0344). Treatment with rifampicin and fluoroquinolone was recorded in 40% of cases. Surgical treatment was performed in 76% of cases, e.g. prosthesis removal (36%), osteosynthesis device removal (24%), and surgical debridement (16%). Thirty perxa0cent of cases were not treated. Relapses were observed mainly in the patients treated by surgical debridement only (pxa00.033). In summary, S.xa0caprae BJI is an underestimated hospital-acquired emerging infection. S.xa0caprae BJI is correlated with infections in orthopaedic devices, which must be removed to control the infection.