Bone and joint infections due to anaerobic bacteria: an analysis of 61 cases and review of the literature

Walter, Gerhard; Vernier, M.; Pinelli, P; Million, Matthieu; Coulange, Mathieu; Seng, Piseth; Stein, Andréas

doi:10.1007/s10096-014-2073-3

Cited by 76 publications

(70 citation statements)

References 65 publications

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“…Anaerobic bone and joint infections (BJI) are uncommon and account for 3 to 4% of BJI (3,4). The most frequently reported anaerobic bacterium involved in BJI is Propionibacterium acnes; other anaerobic bacterial species, such as Bacteroides spp., Clostridium spp., Finegoldia magna, or Peptoniphilus spp., have been reported to occur in orthopedic prosthesis infections, septic arthritis, or osteitis (4,5,6,7).…”

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confidence: 99%

“…The most frequently reported anaerobic bacterium involved in BJI is Propionibacterium acnes; other anaerobic bacterial species, such as Bacteroides spp., Clostridium spp., Finegoldia magna, or Peptoniphilus spp., have been reported to occur in orthopedic prosthesis infections, septic arthritis, or osteitis (4,5,6,7). Little data are available on the medical and surgical management of these infections, and no clear recommendation for the treatment of BJI caused by anaerobic bacteria has been issued.…”

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confidence: 99%

“…Likewise, we had no difficulties identifying R. gnavus by mass spectrometry using the Biotyper version 3.1 database (Bruker Daltonics, Bremen, Germany). The advent of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for the routine diagnosis of bacterial infections in clinical laboratories has improved and facilitated the identification of anaerobic bacteria (4). Indeed, the database currently available has been improved, and new species are regularly included for routine identification of anaerobic bacteria.…”

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confidence: 99%

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Ruminococcus gnavus Total Hip Arthroplasty Infection in a 62-Year-Old Man with Ulcerative Colitis

Roux

Sayed

Duffiet³

et al. 2015

J Clin Microbiol

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We report the case of a total hip arthroplasty infection caused by Ruminococcus gnavus in a 62-year-old man with ulcerative colitis. The bacterium was perfectly identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry. CASE REPORTA 62-year-old man was referred to the orthopedic surgery department of a suburban clinic with suspected prosthetic joint infection (PJI) of the right hip. This patient had undergone total right hip replacement 13 years earlier and had shown no signs of prosthesis dysfunction since surgery.On admission, the patient presented with right hip pain and fever. Biological tests showed elevated white blood cell (18.3 ϫ 10 9 cells/liter) and C-reactive protein (137 mg/liter) levels. No blood culture was collected. Radiological evaluation of the total hip arthroplasty showed a 5-mm subsidence of the femoral stem.Three bone biopsies were performed with a notch needle, and the samples were sent to the microbiology laboratory of the Hôpi-taux Universitaires Paris Ile de France Ouest, Greater Paris, for microbiological analysis. Samples were processed as previously described (1), with continuously monitored broth enrichment. Briefly, samples were topped with 17 ml sterile distilled water and bead milled for 150 s on a Retsch MM300 mixer mill (Verder, France) with 10 to 15 5-mm-diameter stainless steel beads. One hundred microliters of the resulting suspension, plated on 5% sheep blood Columbia agar medium, was incubated for 5 days at 36°C under aerobic and anaerobic conditions, and 6 ml was injected into Bactec Peds Plus and Lytic/10 Anaerobic/F blood culture vials supplemented with a fastidious organism supplement incubated for 14 days in a Bactec FX automated blood culture system (BD Diagnostics, Le Pont de Claies, France). Microscopic examination of the three biopsy samples showed an absence of erythrocytes, numerous polymorphonuclear cells, and Grampositive cocci in short chains. No empirical antibiotic therapy was started after the biopsy. All samples yielded positive cultures on anaerobic medium, with a time to detection of 7 h 7 min for all three Lytic/10 Anaerobic/F vials. On day 1, growth was detected on anaerobic blood agar plates, with numerous translucent small colonies. The diplococci were identified by mass spectrometry (Biotyper version 3.1 on a Microflex LT mass spectrometer, Bruker Daltonics, Bremen, Germany) as Ruminococcus gnavus, with a score of 2.2, and later confirmed by 16S rRNA gene sequencing using previously described primers (2). A 16S rRNA gene fragment of 407 bp was amplified from the bacteria and sequenced on an Applied Biosystems genetic analyzer. GenBank database searches showed the amplified sequences to be 99% (404/ 407 bp) identical to the 16S rRNA gene sequence of the reference strain for R. gnavus ATCC 29149 (GenBank accession no. KP407134). Antimicrobial susceptibility testing by the agar disk diffusion method (Bio-Rad, Marnes-la-Coquette, France) using Comité de l'Antibiogramme de la Société Française de Microbiologie (CA-SFM 20...

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Ruminococcus gnavus Total Hip Arthroplasty Infection in a 62-Year-Old Man with Ulcerative Colitis

Roux

Sayed

Duffiet³

et al. 2015

J Clin Microbiol

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“…It seems to be difficult to identify an anaerobe as a causative pathogen in PVO because the success in the identification of an anaerobe depends on the quality of culture samples, the mode of transport, and the condition of cultures. Furthermore, PVO caused by anaerobic infection tends to occur in the post-surgical site and polymicrobial condition [14]. In the present study, only one patient underwent the operation for lumbar canal stenosis.…”

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confidence: 69%

The Etiology of Pyogenic Vertebral Osteomyelitis and Evaluation of Biopsy Specimen Cultures in Hospitalized Patients

Kamono¹,

Kabeya²,

Sohara³

et al. 2017

J Med Microb Diagn

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Identifying the causative pathogens in patients with pyogenic vertebral osteomyelitis is important for optimizing antibiotic therapy. Thus, we examined patient characteristics and investigated the efficacy of the combined use of blood culture and image-guided biopsy culture for identifying the causative pathogens of pyogenic vertebral osteomyelitis. A case series study was conducted in hospitalized patients who were diagnosed with pyogenic vertebral osteomyelitis using electronic medical records. Twenty-three patients who had undergone both blood culture and image-guided biopsy to determine the causative pathogens were identified. Detailed patient characteristics were identified, and the detection rate of a causative pathogen was 57% using either blood or biopsy specimen culture. By combining the results of each culture, the detection rate was increased to 83%. We described the detailed characteristics of patients with pyogenic vertebral osteomyelitis from whom both blood and biopsy specimen cultures were obtained. We found that the combined use of blood culture and biopsy specimen culture is useful for enhancing the detection of causative pathogens in patients with pyogenic vertebral osteomyelitis.

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“…Les facteurs de risque de mortalité hospitalière identifiés étaient l'infection à Staphylococcus spp. (OR 1,3), l'atteinte des tissus mous (OR 1,9) [2][3][4][5][6]. En France, la proportion de S. aureus résistant à la méticilline (SARM) dans les IOA est proche de 20 %, alors que les taux de résistance à la méticilline sont plus élevés pour les staphylocoques à coagulase négative (40 % à 50 %), impliqués le plus souvent dans les IOA chroniques et postopératoires tardives [3,4,7].…”

Section: éPidémiologie Des Ioa En France Et En Unités De Soins Intensunclassified

Prise en charge des infections ostéo-articulaires sévères en réanimation

et al. 2015

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Les infections ostéo-articulaires (IOA) regroupent des situations cliniques variées, se distinguant par leur site (articulation, rachis, os longs…), leur évolution (aiguë, chronique), la présence ou non de matériel étranger (prothèse articulaire, matériel d'ostéosynthèse), le(s) micro-organisme(s) impliqué(s), le terrain et la voie de contamination (hémato-gène, postopératoire, de contiguïté…). Ces infections sont rares en soins intensifs et concernent des patients en sepsis sévère/choc septique induits par l'IOA ou nécessitant une surveillance en période postopératoire immédiate. La gravité du tableau clinique peut être liée au terrain, aux facteurs de virulence du pathogène et à l'existence d'un abcès ou d'une bactériémie associés à l'infection ostéo-articulaire. Si le diagnostic clinique est en général aisé, le diagnostic microbiologique est souvent difficile du fait de l'urgence à instaurer un traitement antibiotique. La ponction articulaire ou d'une collection para-articulaire est alors l'examen clé pour permettre une documentation microbiologique et sera associée à la réalisa-tion d'hémocultures. Dans ce contexte de soins intensifs, l'antibiothérapie probabiliste aura un large spectre et sera pré-cédée si possible d'une documentation microbiologique permettant d'adapter secondairement le traitement antibiotique. La complexité des paramètres impliqués dans les choix théra-peutiques nécessite une prise en charge multidisciplinaire.

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Bone and joint infections due to anaerobic bacteria: an analysis of 61 cases and review of the literature

Cited by 76 publications

References 65 publications

Ruminococcus gnavus Total Hip Arthroplasty Infection in a 62-Year-Old Man with Ulcerative Colitis

Ruminococcus gnavus Total Hip Arthroplasty Infection in a 62-Year-Old Man with Ulcerative Colitis

The Etiology of Pyogenic Vertebral Osteomyelitis and Evaluation of Biopsy Specimen Cultures in Hospitalized Patients

Prise en charge des infections ostéo-articulaires sévères en réanimation

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