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Athanasiou V, Leonidou L, Lekkou A, Antzoulas P, Solou K, Diamantakis G, Gliatis J. Treatment of Prosthetic Joint Infection due to Listeria Monocytogenes. A Comprehensive Literature Review and a Case of Total Hip Arthroplasty Infection. Arthroplast Today 2022; 13:48-54. [PMID: 34977306 PMCID: PMC8683650 DOI: 10.1016/j.artd.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 11/23/2022] Open
Abstract
As reported in contemporary literature, prosthetic joint infection (PJI) caused by Listeria monocytogenes (LM) is a rare infection affecting mainly immunocompromised patients. It is considered a late complication occurring months or years after the arthroplasty that is treated with, or without, implant retention, in one-stage or two-stage surgical procedures, and long-term administration of antibiotics. We reviewed the published studies in the English language and present a case of a patient who underwent total hip arthroplasty (THA) and had been affected by this infection. Our patient was successfully treated with 3 months of antibiotics (ampicillin and TMP/SMX) and a two-stage surgical procedure. The success rates of conservative treatment and one-stage or two-stage procedures are dependent on appropriate patient selection and chronicity of the infection. Ιmmmunocompromised patients are susceptible to PJI caused by LM and should be advised that consumption of unpasteurized dairy products increases the risk of this atypical infection.
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Affiliation(s)
- Vasileios Athanasiou
- Consultant Orthopaedic Surgeon, Orthopaedic Department, Patras University Hospital, Patra, Greece
| | - Leonidia Leonidou
- Consultant in Internal Medicine, Department of Internal Medicine, Patras University Hospital, Patra, Greece
| | - Alexandra Lekkou
- Consultant in Internal Medicine, Department of Internal Medicine, Patras University Hospital, Patra, Greece
| | - Panagiotis Antzoulas
- Resident in Orthopaedic Surgery, Orthopaedic Department, Patras University Hospital, Patra, Greece
| | - Konstantina Solou
- Resident in Orthopaedic Surgery, Orthopaedic Department, Patras University Hospital, Patra, Greece
| | - Georgios Diamantakis
- Consultant Orthopaedic Surgeon, Orthopaedic Department, Patras University Hospital, Patra, Greece
| | - John Gliatis
- Associate Professor in Orthopaedics, Orthopaedic Department, Patras University Hospital, Patra, Greece
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Hutchins C, Sayavedra L, Diaz M, Gupta P, Tissingh E, Elumogo C, Nolan J, Charles I, Elumogo N, Narbad A. Genomic analysis of a rare recurrent Listeria monocytogenes prosthetic joint infection indicates a protected niche within biofilm on prosthetic materials. Sci Rep 2021; 11:21864. [PMID: 34750463 PMCID: PMC8575960 DOI: 10.1038/s41598-021-01376-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 10/22/2021] [Indexed: 12/13/2022] Open
Abstract
Listeria monocytogenes is a rare cause of prosthetic joint infections (PJI). In this study, we describe a case of recurrent L. monocytogenes infections, 39 months apart, following debridement and retention of a prosthetic hip. Despite numerous studies reporting persistent L. monocytogenes in human infections, the genomic and phenotypic changes that clinically relevant strains undergo in the host are poorly understood. Improved knowledge of how PJI occurs is needed to improve the management of prosthetic infections. We used a combination of long- and short-read sequencing to identify any potential genomic differences between two L. monocytogenes isolates that occurred over 39-month incubation in the host. The isolates, QI0054 and QI0055, showed three single nucleotide polymorphisms and three insertions or deletions, suggesting that the recurrent infection was caused by the same strain. To identify potential differences in the capacity for persistence of these isolates, their biofilm-forming ability and potential to colonize prosthesis-relevant materials was investigated both in microtitre plates and on prosthetic material titanium, stainless steel 316 and ultra-high molecular weight polyethylene. Whilst the L. monocytogenes isolate from the most recent infection (QI0055) was able to form higher biofilm in microtitre plates, this did not lead to an increase in biomass on prosthetic joint materials compared to the initial isolate (QI0054). Both clinical isolates were able to form significantly more biofilm on the two metal prosthetic materials than on the ultra-high molecular weight polyethylene, in contrast to reference strain Scott A. Transcriptomics revealed 41 genes overexpressed in biofilm state and 643 in planktonic state. Moreover, genes with mutations were actively expressed in both isolates. We conclude the isolates are derived from the same strain and hypothesize that L. monocytogenes formed biofilm on the prosthetic joint materials, with minimal exposure to stresses, which permitted their survival and growth.
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Affiliation(s)
- Chloe Hutchins
- Gut Health and Microbes, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.
| | - Lizbeth Sayavedra
- Gut Health and Microbes, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.
| | - Maria Diaz
- Gut Health and Microbes, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.,Microbes in the Food Chain, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK
| | - Puja Gupta
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Elizabeth Tissingh
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Chiamaka Elumogo
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - John Nolan
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Ian Charles
- Gut Health and Microbes, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK.,University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Ngozi Elumogo
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Arjan Narbad
- Gut Health and Microbes, Quadram Institute Bioscience, Norwich Research Park, Norwich, UK
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Schlech WF. Epidemiology and Clinical Manifestations of Listeria monocytogenes Infection. Microbiol Spectr 2019; 7:10.1128/microbiolspec.gpp3-0014-2018. [PMID: 31837132 PMCID: PMC11026082 DOI: 10.1128/microbiolspec.gpp3-0014-2018] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Indexed: 12/21/2022] Open
Abstract
Listeria monocytogenes is a Gram-positive pathogenic bacterium which can be found in soil or water. Infection with the organism can develop after ingestion of contaminated food products. Small and large outbreaks of listeriosis have been described. Listeria monocytogenes can cause a number of clinical syndromes, most frequently sepsis, meningitis, and rhombencephalitis, particularly in immunocompromised hosts. The latter syndrome mimics the veterinary infection in ruminants called "circling disease". Neonatal infection can occur as a result of maternal chorioamnionitis ("early onset" sepsis) or through passage through a birth canal colonized with Listeria from the gastrointestinal tract. ("late onset" meningitis). Treatment of listeriosis is usually with a combination of ampicillin and an aminoglycoside but other regimens have been used. The mortality rate is high, reflecting the combination of an immunocompromised host and an often delayed diagnosis.
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Affiliation(s)
- Walter F Schlech
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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van der Weegen W, Verduin CM, Graumans M, Hoekstra HJ. Successful Debridement of a Knee Joint Prosthesis Infected with Listeria Monocytogenes. Case Report and Review of Current Literature. J Bone Jt Infect 2018; 3:203-206. [PMID: 30416944 PMCID: PMC6215986 DOI: 10.7150/jbji.28146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/27/2018] [Indexed: 12/03/2022] Open
Abstract
According to the relevant literature, prosthetic joint infections caused by Listeria monocytogenes require two stage revision surgery or prosthesis removal for a successful outcome. We present the case of a patient who suffered such an infection after Total Knee Replacement surgery and was successfully treated with antibiotics, joint lavage, debridement and retention of the prosthesis.
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Affiliation(s)
- Walter van der Weegen
- Department of orthopedic surgery, St. Anna hospital, Bogardeind 2, 5664 EH, Geldrop, the Netherlands
| | - Cees M Verduin
- Department of medical microbiology, Laboratory for Pathology and Medical Microbiology (Stichting PAMM), De Run 6250, 5504 DL, Veldhoven, the Netherlands
| | - Miriam Graumans
- Department of Infection control, St. Anna hospital, Bogardeind 2, 5664 EH, Geldrop, the Netherlands
| | - Henk J Hoekstra
- Department of orthopedic surgery, St. Anna hospital, Bogardeind 2, 5664 EH, Geldrop, the Netherlands
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Thompson AB, Wrubel D, Berkowitz FE. Gram-Positive Rods on a Cerebrospinal Fluid Gram Stain. Open Forum Infect Dis 2017; 4:ofx240. [PMID: 29255736 PMCID: PMC5726465 DOI: 10.1093/ofid/ofx240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cerebrospinal fluid (CSF) access device placement in the pediatric population presents challenges due to the development of infections following placement, access or revision, and/or shunt malfunctions. Here we report an unusual pediatric case of L. monocytogenes ventriculitis/VP shunt (VPS) infection and associated pseudocyst with an emphasis on the importance of VPS removal in clearing the infection due to biofilm formation.
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Affiliation(s)
- Amelia B Thompson
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Pediatrics, Division of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David Wrubel
- Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Frank E Berkowitz
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
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Bader G, Al-Tarawneh M, Myers J. Review of Prosthetic Joint Infection from Listeria monocytogenes. Surg Infect (Larchmt) 2016; 17:739-744. [PMID: 27513716 DOI: 10.1089/sur.2016.067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prosthetic joint infection from Listeria monocytogenes is rare. We decided to shed light on this illness and review the reported cases to better understand its characteristics. PATIENTS AND METHODS We conducted a comprehensive review of the English literature using PubMed. We also included one case that we had managed. RESULTS We found 25 cases of prosthetic joint infection from L. monocytogenes reported individually and a retrospective study of 43 cases of joint and bone listerial infection, including 34 with prosthetic joint infection, conducted in France. We have described their clinical and para-clinical features and tried to elaborate on the pathophysiology, treatment, and prevention. CONCLUSION Prosthetic joint infection from L. monocytogenes is mainly late. Systemic inflammation may be absent. Although rare, it must be suspected in patients at high risk for both prosthetic joint and listerial infections. In addition, those patients must be instructed on appropriate preventive measures.
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Affiliation(s)
- Gilbert Bader
- 1 Division of Internal Medicine, East Tennessee State University , Johnson City, Tennessee
| | - Mohammed Al-Tarawneh
- 2 Division of Infectious Diseases, East Tennessee State University , Johnson City, Tennessee
| | - James Myers
- 2 Division of Infectious Diseases, East Tennessee State University , Johnson City, Tennessee
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