Recovery of Small Colony Variants of<i>Staphylococcus aureus</i>Following Gentamicin Bead Placement for Osteomyelitis

Eiff, Christof von; Bettin, D.; Proctor, Richard A.; Rolauffs, Bernd; Lindner, Norbert; Winkelmann, Winfried; Peters, Georg

doi:10.1086/516962

Cited by 231 publications

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“…Microbiological investigation of implants is complicated due to the sizes of the prosthetic components and problems associated with conventional culture, i.e., presence of intracellular bacteria, microorganisms in biofilm, and small-colony variants of bacteria (1,5,9,14), the last of which may be induced after treatment with gentamicin (26).…”

mentioning

confidence: 99%

In Vitro Effect of Ultrasound on Bacteria and Suggested Protocol for Sonication and Diagnosis of Prosthetic Infections

Lövgren²,

et al. 2009

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Sonication of implants has been shown to be a promising method for diagnosis of prosthetic infections due to its improved sensitivity, simplicity, and low cost. The aim of the present study was to evaluate the effects of ultrasound performed under different conditions regarding temperature, duration, and composition of sonication tubes on bacterial species often associated with prosthetic infections. We found that ultrasound had an inhibitory effect on bacteria, of which gram-negative bacteria, in particular Escherichia coli, were almost eradicated after 5 min of sonication at 35°C. Gram-positive bacteria were found to be resistant to the effect of ultrasound. Four factors were important for the inhibitory effect of sonication: the type of microorganism, the temperature of the sonication buffer, the duration of exposure to ultrasound (minutes), and the material and composition of the sonication tube in which sonication is performed. On the basis of the results from the present study, we propose a protocol for sonication and recovery of bacteria associated with biofilm on infected implants prior to conventional culture. From the present protocol, we recommend sonication for 7 min at 22°C at the maximum effect which permits survival of gram-negative bacteria.

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confidence: 99%

In Vitro Effect of Ultrasound on Bacteria and Suggested Protocol for Sonication and Diagnosis of Prosthetic Infections

Lövgren²,

et al. 2009

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“…No long-term antibiotic therapy and thus no antibiotic pressures were documented in our patient, which might explain the selection of such bacterial forms. Nevertheless, the cement of the primary arthroplasty contained gentamicin, which can select for SCVs in staphylococci (37). Serial passages revealed different S. tigurinus SCV phenotypes: strain 2425 retained a very stable SCV phenotype, whereas strain 2426 showed a fluctuating phenotype, with reversion to normal-sized colonies and back to SCVs after further passages.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Streptococcus tigurinus Small-Colony Variants Causing Prosthetic Joint Infection by Comparative Whole-Genome Analyses

et al. 2014

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Small-colony variants (SCVs) of bacteria are associated with recurrent and persistent infections. We describe for the first time SCVs of Streptococcus tigurinus in a patient with a prosthetic joint infection. S. tigurinus is a novel pathogen of the Streptococcus mitis group and causes invasive infections. We sought to characterize S. tigurinus SCVs using experimental methods and find possible genetic explanations for their phenotypes. The S. tigurinus SCVs were compared with the wild-type (WT) isolate using phenotypic methods, including growth under different conditions, autolysis, and visualization of the cell ultrastructure by use of transmission electron microscopy (TEM). Furthermore, comparative genome analyses were performed. The S. tigurinus SCVs displayed reduced growth compared to the WT and showed either a very stable or a fluctuating SCV phenotype. TEM analyses revealed major alterations in cell separation and morphological abnormalities, which were partially explained by impaired autolytic behavior. Intriguingly, the SCVs were more resistant to induced autolysis. Whole-genome sequencing revealed mutations in the genes involved in general cell metabolism, cell division, stringent response, and virulence. Clinically, the patient recovered after a 2-stage exchange of the prosthesis. Comparative whole-genome sequencing in clinical strains is a useful tool for identifying novel genetic signatures leading to the most persistent bacterial forms. The detection of viridans streptococcal SCVs is challenging in a clinical laboratory due to the small colony size. Thus, it is of major clinical importance for microbiologists and clinicians to be aware of viridans streptococcal SCVs, such as those of S. tigurinus, which lead to difficult-to-treat infections.

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“…Once internalized bacteria can escape the phagosome and cause necrosis (Wright & Nair, 2010). Slow growing variants (called small colony variants) often emerge allowing the bacteria and the infection to persist (von Eiff, Bettin et al, 1997). These bacteria are mutant forms of Staphylococcus that may have an adaptive advantage enabling persistent bone colonisation.…”

Section: Role Of Osteoblastsmentioning

confidence: 99%

Pathophysiology and Pathogenesis of Osteomyelitis

Roy¹,

Somerson²,

Kerr³

et al. 2012

Osteomyelitis

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Recovery of Small Colony Variants ofStaphylococcus aureusFollowing Gentamicin Bead Placement for Osteomyelitis

Cited by 231 publications

References 0 publications

In Vitro Effect of Ultrasound on Bacteria and Suggested Protocol for Sonication and Diagnosis of Prosthetic Infections

In Vitro Effect of Ultrasound on Bacteria and Suggested Protocol for Sonication and Diagnosis of Prosthetic Infections

Characterization of Streptococcus tigurinus Small-Colony Variants Causing Prosthetic Joint Infection by Comparative Whole-Genome Analyses

Pathophysiology and Pathogenesis of Osteomyelitis

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