No change in the distribution of types and antibiotic resistance in clinical Staphylococcus aureus isolates from orthopaedic patients during a period of 12 years

Eur J Clin Microbiol Infect Dis. 2015 Sep;34(9):1833-7. doi: 10.1007/s10096-015-2420-z. Epub 2015 Jun 16.

Abstract

Staphylococcus aureus (S. aureus) is the most common cause of bone and joint infections. However, limited information is available on the distribution of S. aureus geno- and phenotypes causing orthopaedic infections. The aim of this study was to identify the dominating types causing infections in orthopaedic patients, investigate if the characteristics of these types changed over time and examine if different types were more often associated with surgical site infection (SSI) than primary infection (non-SSI). All clinical S. aureus isolates collected from orthopaedic patients from 2000 through 2011 at Akershus University Hospital, Norway, were characterised by S. aureus protein A (spa) typing and tested for antibiotic resistance. A total of 548 patients with orthopaedic S. aureus infections were included, of which 326 (59 %) had SSI and 222 (41 %) had non-SSI. The median age was 62 years [range 2-97 years] and 54 % were male. Among the 242 unique spa types, t084 was the most common (7 %). Penicillin resistance was identified in 75 % of the isolates, whereas the resistances to the other antibiotics tested were <5 %. Three isolates (0.5 %) were resistant to methicillin. There was no significant difference in the distribution of geno- and phenotypes over time and there was no difference in types between SSI and non-SSI. In this large collection of S. aureus from orthopaedic patients, the S. aureus infections, regardless of origin, were heterogeneous, mainly resistant to penicillin, stable over time and consisted of similar types as previously found in both carrier and other patient populations.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Typing Techniques
  • Bone Diseases, Infectious / drug therapy
  • Bone Diseases, Infectious / microbiology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cross Infection / microbiology
  • Drug Resistance, Bacterial
  • Female
  • Humans
  • Joint Diseases / drug therapy
  • Joint Diseases / microbiology*
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Orthopedic Procedures / adverse effects
  • Prospective Studies
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / microbiology
  • Staphylococcal Protein A / genetics
  • Staphylococcus aureus / classification
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / isolation & purification*
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / microbiology*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Staphylococcal Protein A