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Manceau L, Bémer P, Decroo J, Jolivet-Gougeon A, Plouzeau C, Lartigue MF, Bouard L, Chenouard R, Mazuet C, Leroy AG. Clostridial prosthetic joint infections: A series of 16 cases and literature review. Infect Dis Now 2023; 53:104776. [PMID: 37648080 DOI: 10.1016/j.idnow.2023.104776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES Prosthetic joint infections (PJIs) due to the Clostridium species have not been widely investigated. We aimed to characterize these uncommon infections. METHODS We conducted a retrospective study between 2003 and 2020 in six French hospitals combined with a review of the literature. RESULTS The main conclusions obtained from the 16 patients included were reinforced by the literature analysis: (i) Clostridium perfringens was the most frequently involved species, (ii) patients presented an advanced age at the time of prosthesis placement and infection, (iii) most of the infections were early- or delayed-onset, (iv) the prognosis for these PJIs remains poor, (v) when performed (n = 5), DAIR with 12-week antimicrobial therapy led to a favorable outcome in 80% of cases. CONCLUSIONS Given the low incidence of this infection, our work represents the largest series of clostridial PJIs reported to date and highlights some specificities of these infections. Further prospective studies are needed to confirm these results.
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Affiliation(s)
- L Manceau
- Université de Nantes, CHU Nantes, Service de Bactériologie et des Contrôles Microbiologiques, F-44000 Nantes, France
| | - P Bémer
- Université de Nantes, CHU Nantes, Service de Bactériologie et des Contrôles Microbiologiques, F-44000 Nantes, France
| | - J Decroo
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, CIC-UIC 1413 INSERM, Nantes, France
| | - A Jolivet-Gougeon
- Univ Rennes, INSERM, INRAE, CHU de Rennes, Institut NUMECAN (Nutrition Metabolims and Cancer), U1241, Microbiology, F-35000 Rennes, France
| | - C Plouzeau
- CHU de Poitiers, Department of Microbiology, Poitiers, France
| | - M-F Lartigue
- Service de Bactériologie-Virologie-Hygiène, Centre Hospitalier Universitaire de Tours, Tours, France; ISP, Université de Tours, INRAE, Tours, France
| | - L Bouard
- GCS biologie 85, CHD Vendée, Laboratoire de biologie médicale, La-Roche-Sur-Yon, France
| | - R Chenouard
- CHU de Angers, Department of Bacteriology, Angers, France
| | - C Mazuet
- National Reference Center for Anaerobic Bacteria and Botulism, Institut Pasteur, Paris, France
| | - A-G Leroy
- Université de Nantes, CHU Nantes, Service de Bactériologie et des Contrôles Microbiologiques, F-44000 Nantes, France; Laboratoire de Microbiologie, CHU Sud Réunion, Saint-Pierre, La Réunion, France.
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Khubaib MU, Stark BE, Gross B, Gross ML, Vazquez O. A Rare Case of Septic Knee Arthritis Caused by Clostridium perfringens in a Patient With Colostomy. Cureus 2021; 13:e16823. [PMID: 34522480 PMCID: PMC8425027 DOI: 10.7759/cureus.16823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/30/2022] Open
Abstract
Septic arthritis of the knee is commonly caused by aerobic organisms. Rarely, it can be caused by Clostridium perfringens, usually due to penetrating trauma. This is a rare case of C. perfringens septic arthritis in a patient with colostomy due to hematogenous spread. The patient was treated successfully with a synovectomy and a prolonged intravenous antibiotic course. The case report summarizes the existing literature on the topic and discusses the diagnosis, management, and prognosis of such cases as well.
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Affiliation(s)
| | - Brett E Stark
- Orthopaedic Surgery, Active Orthopedics & Sports Medicine, Hackensack, USA
| | - Benjamin Gross
- Sports Medicine, Active Orthopedics & Sports Medicine, Hackensack, USA
| | - Michael L Gross
- Sports Medicine, Active Orthopedics & Sports Medicine, Hackensack, USA
| | - Oscar Vazquez
- Sports Medicine, Active Orthopedics & Sports Medicine, Hackensack, USA
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Rodríguez Duque JC, Galindo Rubín P, González Humara B, Quesada Sanz AA, Busta Vallina MB, Fernández-Sampedro M. Fusobacterium nucleatum prosthetic hip infection: Case report and review of the literature of unusual anaerobic prosthetic joint infection. Anaerobe 2018; 54:75-82. [PMID: 30118892 DOI: 10.1016/j.anaerobe.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 07/26/2018] [Accepted: 08/12/2018] [Indexed: 12/26/2022]
Abstract
The anaerobic Gram-negative rod Fusobacterium nucleatum is an oral commensal and periodontal pathogen that has been associated with a wide variety of infections, yet it is extremely rare to be associated with prosthetic joint infection. After an exhaustive literature review, only two cases of prosthetic joint infection by F. nucleatum have been previously reported. To our knowledge, the case we report on here is the first combined with periprosthetic abscess and related with hemochromatosis. We therefore sought to provide a comprehensive literature review of case reports or series of less commonly encountered anaerobic microorganisms isolated from prosthetic joint infections.
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Affiliation(s)
- J C Rodríguez Duque
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - P Galindo Rubín
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - B González Humara
- Department of Radiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - A A Quesada Sanz
- Service of Microbiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M B Busta Vallina
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M Fernández-Sampedro
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
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García-Jiménez A, Prim N, Crusi X, Benito N. Septic arthritis due to Clostridium ramosum. Semin Arthritis Rheum 2016; 45:617-20. [PMID: 26546506 DOI: 10.1016/j.semarthrit.2015.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 09/07/2015] [Accepted: 09/28/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Clostridium species are anaerobic bacilli that are rarely reported as etiologic agents of infectious arthritis. Previous cases of arthritis caused by Clostridium ramosum have not been reported. We describe the first 2 cases of C. ramosum arthritis. METHODS We reviewed the etiology of arthritis in our hospital during the previous 15 years. RESULTS Both patients had underlying immunocompromising conditions and their infections involved a joint with preexisting disease: patient 1 had rheumatic arthritis and a prosthetic joint; patient 2, chronic renal failure on dialysis and hip osteoarthritis. The infection was hematogenously acquired and the course was indolent but destructive in both the cases. Management included open arthrotomy and resection arthroplasty. The infection had a persisting and relapsing course, and prolonged antibiotic treatment was required. In the literature review, we found 55 previous cases of arthritis caused by Clostridium species between 1966 and 2014; Clostridium perfringens was the most common infecting species; the infection was traumatically acquired in most of the cases. A total of 15 patients have been described with infections caused by C. ramosum; none had septic arthritis. The majority were elderly or immunocompromised adults. Proper collection, transportation and processing of clinical specimens is essential for diagnosing clostridial infections. More information about the best management of clostridial arthritis are needed. CONCLUSIONS We describe the first 2 cases of septic arthritis caused by C. ramosum. They shared several pathogenic and clinical features. The possibility of anaerobic arthritis should always be considered when collecting diagnostic specimens. An increasing number of clostridial arthritis cases are likely to be diagnosed in future years.
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Affiliation(s)
- Antonio García-Jiménez
- Department of Orthopedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Núria Prim
- Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Xavier Crusi
- Department of Orthopedic Surgery and Traumatology, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau, Barcelona, Spain
| | - Natividad Benito
- Infectious Diseases Unit, Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Institut d׳Investigació Biomèdica Sant Pau, Sant Antoni Maria Claret, 167, Barcelona 08025, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain.
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Vuotto C, Donelli G. Anaerobes in Biofilm-Based Healthcare-Associated Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 830:97-112. [DOI: 10.1007/978-3-319-11038-7_6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Mallozzi M, Viswanathan VK, Vedantam G. Spore-forming Bacilli and Clostridia in human disease. Future Microbiol 2010; 5:1109-23. [DOI: 10.2217/fmb.10.60] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Many Gram-positive spore-forming bacteria in the Firmicute phylum are important members of the human commensal microbiota, which, in rare cases, cause opportunistic infections. Other spore-formers, however, have evolved to become dedicated pathogens that can cause a striking variety of diseases. Despite variations in disease presentation, the etiologic agent is often the spore, with bacterially produced toxins playing a central role in the pathophysiology of infection. This review will focus on the specific diseases caused by spores of the Clostridia and Bacilli.
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Affiliation(s)
- Michael Mallozzi
- Department of Veterinary Science and Microbiology, University of Arizona, 1117, East Lowell St., Building 90, Room 303, Tucson, AZ 85721, USA
| | - VK Viswanathan
- Department of Veterinary Science and Microbiology, University of Arizona, 1117, East Lowell St., Building 90, Room 303, Tucson, AZ 85721, USA
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