Journal Article

Epidemiology and risk factors of Staphylococcus aureus CC398 bone and joint infections

Hocquet, Didier, Bertrand, Xavier, Bouiller, Kevin, Sauget, Marlene, Chirouze, Catherine

2020

Overview

Background A particular ability of the Staphylococcus aureus clonal complex 398 (CC398) to cause bone and joint infections (BJI) remains questionable, since some studies have described high prevalence of MSSA CC398 in prosthetic joint infection (PJI) and diabetic foot ostemolyelitis (DFO). Here, we described the long-term epidemiology of CC398 among S. aureus isolated from BJI and identified risk factors associated with CC398. Methods We included all bone and joint samples with S. aureus -positive culture in our university hospital between January 2010 and December 2017. Logistic regression was used for univariate and multivariate analysis. Results We identified 124 CC398 isolates among the 958 BJI-associated S. aureus . The proportion of CC398 among S. aureus increased steadily from 4% in 2010 to 26% in 2017. Only 4 isolates of CC398 were resistant to methicillin. The distribution of BJI types due to CC398 and non CC398 isolates was similar. In multivariate analysis, age ( p  = 0.034, OR = 3.9), McCabe score ( p  = 0.005, OR = 5) and inoculation mechanism ( p  = 0.020, OR = 3.7) were associated with PJI-related CC398. The year of infection ( p  < 0.001, OR = 1.6), Charlson’s score ( p  = 0.001, OR = 1.5) and grade 4 (severe) of the International Working Group of the Diabetic Foot classification ( p  < 0.001, OR = 8.5) were associated with DFO-related CC398. Conclusion We highlighted here the emergence and spread of CC398-MSSA in BJI. Patients with comorbidities are at high risk of CC398 MSSA PJI and DFO. The spread of CC398 in the community and hospital settings remains unclear and further epidemiological studies are needed to identify the determinants of its success.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Aged, 80 and over / Arthritis, Infectious / Bacterial and fungal diseases / Bacteriology / Bone joint infection / CC398 / Cloning / Communicable Diseases / Comorbidity / Diabetes / Diabetes mellitus / Diabetic Foot / Diabetic foot infection / Disease / Disease susceptibility / Epidemiology / Feet / Female / Foot diseases / Health aspects / Hospitals / Hospitals, University / Human health and pathology / Human ST398 / Humans / Identification methods / Infection / Infectious Diseases / Inoculation / Internal Medicine / Joint diseases / Joint surgery / Joints (anatomy) / Life Sciences / Livestock / Male / Medical Microbiology / Medicine / Medicine & Public Health / Methicillin / Methicillin susceptible Staphylococcus aureus / Methicillin-Resistant Staphylococcus aureus / Microbiology and Parasitology / Middle Aged / Multivariate analysis / Osteomyelitis / Parasitology / Penicillin / Polymerase Chain Reaction / Prevalence / Prevalence studies (Epidemiology) / Prostheses / Prostheses and implants / Prosthetic joint infection / Regression analysis / Research Article / Retrospective Studies / Rhumatology and musculoskeletal system / Risk analysis / Risk Factors / Santé publique et épidémiologie / Staphylococcal Infections / Staphylococcus aureus / Staphylococcus aureus infections / Staphylococcus infections / Studies / Tropical Medicine / Virulence