Second Periprosthetic Joint Infection Caused by Streptococcus dysgalactiae: How Genomic Sequencing Can Help Defining the Best Therapeutic Strategy

Truong-Thanh Pham; Vladimir Lazarevic; Nadia Gaia; Myriam Girard; Abdessalam Cherkaoui; Domizio Suva; Jacques Schrenzel

doi:10.3389/fmed.2020.00053

Second Periprosthetic Joint Infection Caused by Streptococcus dysgalactiae: How Genomic Sequencing Can Help Defining the Best Therapeutic Strategy

Front Med (Lausanne). 2020 Feb 21:7:53. doi: 10.3389/fmed.2020.00053. eCollection 2020.

Authors

Truong-Thanh Pham^{1

2}, Vladimir Lazarevic³, Nadia Gaia³, Myriam Girard³, Abdessalam Cherkaoui⁴, Domizio Suva², Jacques Schrenzel^{1

3

4}

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
² Division of Orthopedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.
³ Genomic Research Laboratory, Division of Infectious Diseases, Department of Medicine, Faculty of Medicine Geneva, Geneva University Hospitals, Geneva, Switzerland.
⁴ Bacteriology Laboratory, Department of Diagnostic, Geneva University Hospitals, Geneva, Switzerland.

Abstract

Primary and revision arthroplasties are increasing worldwide, as are periprosthetic joint infections (PJI). The management of PJI requires surgery, the strategy of which is dictated by the acute or chronic nature of the infection, with an exchange of the implant in the event of a chronic PJI or in the case of recurrence with the same pathogen. We report the case of a 63-year-old man with two episodes of Streptococcus dysgalactiae subsp. equisimilis PJI within 9 months. Based on clinical suspicion of an haematogenous PJI, the patient was treated by DAIR (debridement, antibiotics, implant retention), while genomic sequencing revealed two different strains, confirming our hypothesis that no additional surgery was needed. Hence, we report a case where genomic analysis was decisive for the decision of the best therapeutic strategy.

Keywords: NGS; PJI; Streptococcus dysgalactiae; next-generation sequencing; periprosthetic joint infection.

Publication types

Case Reports