Acute Prosthetic Joint Infections with Poor Outcome Caused by Staphylococcus Aureus Strains Producing the Panton–Valentine Leukocidin
Martina Maritati,
Marco Manfrini,
Maria Rosa Iaquinta,
Alessandro Trentini,
Silva Seraceni,
Matteo Guarino,
Anna Costanzini,
Roberto De Giorgio,
Gustavo Alberto Zanoli,
Alessandro Borghi,
Elisa Mazzoni,
Giuseppe De Rito,
Carlo Contini
Affiliations
Martina Maritati
Department of Medical Sciences, Infectious Diseases and Dermatology Section, University of Ferrara, Via Aldo Moro, 44124 Ferrara, Italy
Marco Manfrini
Department of Medical Sciences, Centre for Clinical and Epidemiological Research, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
Maria Rosa Iaquinta
Department of Medical Sciences, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
Alessandro Trentini
Department of Environmental Sciences and Prevention, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
Silva Seraceni
Department of Medical Sciences, Infectious Diseases and Dermatology Section, University of Ferrara, Via Aldo Moro, 44124 Ferrara, Italy
Matteo Guarino
Department of Translational Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
Anna Costanzini
Department of Translational Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
Roberto De Giorgio
Department of Translational Medicine, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
Gustavo Alberto Zanoli
Orthopaedic Ward, Casa di Cura Santa Maria Maddalena, Via Gorizia, Occhiobello, 45030 Rovigo, Italy
Alessandro Borghi
Department of Medical Sciences, Infectious Diseases and Dermatology Section, University of Ferrara, Via Aldo Moro, 44124 Ferrara, Italy
Elisa Mazzoni
Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
Giuseppe De Rito
Orthopaedic Ward, Casa di Cura Santa Maria Maddalena, Via Gorizia, Occhiobello, 45030 Rovigo, Italy
Carlo Contini
Department of Medical Sciences, Infectious Diseases and Dermatology Section, University of Ferrara, Via Aldo Moro, 44124 Ferrara, Italy
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 p < 0.04). In this setting, toxin research should guide radical surgical treatment and targeted antibiotic therapy.
