Bone and Joint Infection Involving Corynebacterium spp.: From Clinical Features to Pathophysiological Pathways

Frontiers in Medicine

article

Pierre Chauvelot¹  Frédéric Laurent²  Florent Valour⁵  Tristan Ferry²  Virginie Tafani³  Alan Diot³  Jason Tasse³  Anne Conrad⁵  Christian Chidiac⁵  Evelyne Braun⁵  Sébastien Lustig² 

[1] Departement of Infectious Diseases;French Regional Reference Center for Complex Bone and Joint Infection (CRIOAc);International Centre for Research in Infectiology, Claude Bernard Lyon 1 University;Laboratory of bacteriology, French National Reference Centre for Staphylococci;Departement of Infectious Diseases, Hospices Civils de Lyon;BioFilm Control;Orthopedic Surgery Unit

关键词: Corynebacterium;    osteoblasts;    biofilm;    bone and joint infection;    intracellular;   

DOI  :  10.3389/fmed.2020.539501

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Introduction: Corynebacteria represent often-neglected etiological agents of post-traumatic and/or post-operative bone and joint infection (BJI). We describe here clinical characteristics and bacteriological determinants of this condition. Methods: A retrospective cohort study described characteristics, outcome and determinants of treatment failure of all patients with proven Corynebacterium spp. BJI (i.e., ≥2 culture-positive gold-standard samples). Available strains were further characterized regarding their antibiotic susceptibilies, abilities to form early (BioFilm Ring Test®) and mature (crystal violet staining method) biofilms and to invade osteoblasts (gentamicin protection assay). Results: The 51 included BJI were mostly chronic (88.2%), orthopedic device-related (74.5%) and polymicrobial (78.4%). After a follow-up of 60.7 weeks (IQR, 30.1–115.1), 20 (39.2%) treatment failures were observed, including 4 Corynebacterium -documented relapses, mostly associated with non-optimal surgical management (OR 7.291; p = 0.039). Internalization rate within MG63 human osteoblasts was higher for strains isolated from delayed (>3 months) BJI ( p < 0.001). Infection of murine osteoblasts deleted for the β1-integrin resulted in a drastic reduction in the internalization rate. No difference was observed regarding biofilm formation. Conclusions: Surgical management plays a crucial role in outcome of BJI involving corynebacteria, as often chronic and device-associated infections. Sanctuarisation within osteoblasts, implicating the β1 cellular integrin, may represent a pivotal virulence factor associated with BJI chronicity.

【 授权许可】

CC BY