Pediatric Community-Acquired Bone and Joint Staphylococcus Aureus Infections In Europe

Gijón, Manuel; Bellusci, Marcello; Petraitienė, Birutė; Noguera-Julián, Antoni; Glikman, Daniel; Saavedra-Lozano, Jesús; Neth, Olaf; Daskalaki, Maria; Žilinskaitė, Virginija; Kaiser-Labusch, Petra; Prieto, Luís; Rojo, Pablo

doi:10.1097/inf.0000000000002640

Cited by 17 publications

(16 citation statements)

References 18 publications

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“…PVL production, on the other hand, has not been associated with an risk invasive infection or bacteremia during PJI, in contrast to other reports in the literature [36,38].…”

Section: Discussioncontrasting

confidence: 77%

Acute Prosthetic Joint Infections with Poor Outcome Caused by Staphylococcus Aureus Strains Producing the Panton–Valentine Leukocidin

et al. 2023

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The aim of this study was to investigate whether the presence of Staphylococcus aureus (SA) producing the Panton–Valentine leukocidin (PVL) affects the outcome of Prosthetic Joint Infection (PJI). Patients with acute and chronic PJI sustained by SA were prospectively enrolled at the orthopedic unit of “Casa di Cura Santa Maria Maddalena”, from January 2019 to October 2021. PJI diagnosis was reached according to the diagnostic criteria of the International Consensus Meeting on PJI of Philadelphia. Synovial fluid obtained via joint aspirations was collected in order to isolate SA. The detection of PVL was performed via real-time quantitative PCR (RT-qPCR). The outcome assessment was performed using the criteria of the Delphi-based International Multidisciplinary Consensus. Twelve cases of PJI caused by SA were included. Nine (75%) cases were acute PJI treated using debridement, antibiotic and implant retention (DAIR); the remaining three (25%) were chronic PJI treated using two-stage (n = 2) and one-stage revision (n = 1), respectively. The SA strains that tested positive for PVL genes were 5/12 (41.6%,). Treatment failure was documented in three cases of acute PJI treated using DAIR, all supported by SA–PVL strains (p < 0.045). The remaining two cases were chronic PJI treated with a revision arthroplasty (one and two stage, respectively), with a 100% eradication rate in a medium follow-up of 24 months. Although a small case series, our study showed a 100% failure rate in acute PJI, probably caused by SA PVL-producing strains treated conservatively (p < 0.04). In this setting, toxin research should guide radical surgical treatment and targeted antibiotic therapy.

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“…PVL production, on the other hand, has not been associated with an risk invasive infection or bacteremia during PJI, in contrast to other reports in the literature [36,38].…”

Section: Discussioncontrasting

confidence: 77%

Acute Prosthetic Joint Infections with Poor Outcome Caused by Staphylococcus Aureus Strains Producing the Panton–Valentine Leukocidin

et al. 2023

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“…( 33 ). As infections assigned to S. aureus harboring this cytotoxin might be associated with higher disease severity ( 15 , 16 , 34 ), we recommend testing of PVL in each case of POAI caused by S. aureus . According to the European Society for Paediatric Infectious Diseases (ESPID) guidelines, adjunctive therapy with, e.g., clindamycin to inhibit toxin production is beneficial ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Osteoarticular Infections in Pediatric Hospitals in Europe: A Prospective Cohort Study From the EUCLIDS Consortium

et al. 2022

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BackgroundPediatric osteoarticular infections (POAIs) are serious diseases requiring early diagnosis and treatment.MethodsIn this prospective multicenter cohort study, children with POAIs were selected from the European Union Childhood Life-threatening Infectious Diseases Study (EUCLIDS) database to analyze their demographic, clinical, and microbiological data.ResultsA cohort of 380 patients with POAIs, 203 with osteomyelitis (OM), 158 with septic arthritis (SA), and 19 with both OM and SA, was analyzed. Thirty-five patients were admitted to the Pediatric Intensive Care Unit; out of these, six suffered from shock, one needed an amputation of the right foot and of four left toes, and two had skin transplantation. According to the Pediatric Overall Performance Score, 36 (10.5%) showed a mild overall disability, 3 (0.8%) a moderate, and 1 (0.2%) a severe overall disability at discharge. A causative organism was detected in 65% (247/380) of patients. Staphylococcus aureus (S. aureus) was identified in 57.1% (141/247) of microbiological confirmed cases, including 1 (0.7%) methicillin-resistant S. aureus (MRSA) and 6 (4.2%) Panton-Valentine leukocidin (PVL)-producing S. aureus, followed by Group A Streptococcus (18.2%) and Kingella kingae (8.9%). K. kingae and PVL production in S. aureus were less frequently reported than expected from the literature.ConclusionPOAIs are associated with a substantial morbidity in European children, with S. aureus being the major detected pathogen. In one-third of patients, no causative organism is identified. Our observations show an urgent need for the development of a vaccine against S. aureus and for the development of new microbiologic diagnostic guidelines for POAIs in European pediatric hospitals.

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“…Une autre particularité du Staphylococcus aureus est sa possible production de toxine Leucocidine de Panton et Valentine (LPV). Cette production de LPV est associée à des infections invasives plus sévères et plus à risque de complications (42). Cela concerne en particulier les infections cutanées, les IOA et les pneumopathies infectieuses (22,43,44).…”

Section: B -Stades éVolutifsunclassified

“…La part des Staphylococcus aureus producteurs de LPV (SA LPV+) est très inégale selon les régions du monde (22). Une étude française de 1995 montrait une prévalence des SA LPV+ parmi les Staphylococcus aureus de 2 % (45), mais une étude européenne multicentrique de 2016 montre des chiffres plus importants : 18,6 % (42). Les SA LPV+ seraient plus représentés parmi les SARM que parmi les Staphylococcus aureus sensible à la méticilline (SASM) (46).…”

Section: B -Stades éVolutifsunclassified

“…Les auteurs évoquaient le rôle de la toxine LPV fréquemment retrouvée pour expliquer cette autre voie physiopathologique. En effet, la toxine LPV est incriminée, par son action « pyogène », dans la survenue de complications loco-régionales, en particulier dans les IOA (42,43). Elle est particulièrement fréquente à Mayotte (Tableau 32).…”

Section: -Diagnostic De L'infectionunclassified

See 1 more Smart Citation

État des lieux des ostéomyélites hématogènes de l’enfant et de l’adulte à Mayotte : étude rétrospective des cas hospitalisés au centre hospitalier de Mayotte entre 2014 et 2017

Brard

Hoarau²,

Diallo³

2019

Médecine et Maladies Infectieuses

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Pediatric Community-Acquired Bone and Joint Staphylococcus Aureus Infections In Europe

Cited by 17 publications

References 18 publications

Acute Prosthetic Joint Infections with Poor Outcome Caused by Staphylococcus Aureus Strains Producing the Panton–Valentine Leukocidin

Acute Prosthetic Joint Infections with Poor Outcome Caused by Staphylococcus Aureus Strains Producing the Panton–Valentine Leukocidin

Osteoarticular Infections in Pediatric Hospitals in Europe: A Prospective Cohort Study From the EUCLIDS Consortium

État des lieux des ostéomyélites hématogènes de l’enfant et de l’adulte à Mayotte : étude rétrospective des cas hospitalisés au centre hospitalier de Mayotte entre 2014 et 2017

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