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Article Dans Une Revue Frontiers in Medicine Année : 2021

Bone and Joint Infection Involving Corynebacterium spp.: From Clinical Features to Pathophysiological Pathways

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Introduction: Corynebacteria represent often-neglected etiological agents of post-traumatic and/or post-operative bone and joint infection (BJI). We describe here clinical characteristics and bacteriological determinants of this condition. Methods: A retrospective cohort study described characteristics, outcome and determinants of treatment failure of all patients with proven Corynebacterium spp. BJI (i.e., ?2 culture-positive gold-standard samples). Available strains were further characterized regarding their antibiotic susceptibilies, abilities to form early (BioFilm Ring Test®) and mature (crystal violet staining method) biofilms and to invade osteoblasts (gentamicin protection assay). Results: The 51 included BJI were mostly chronic (88.2%), orthopedic device-related (74.5%) and polymicrobial (78.4%). After a follow-up of 60.7 weeks (IQR, 30.1-115.1), 20 (39.2%) treatment failures were observed, including 4 Corynebacterium-documented relapses, mostly associated with non-optimal surgical management (OR 7.291; p = 0.039). Internalization rate within MG63 human osteoblasts was higher for strains isolated from delayed (>3 months) BJI (p < 0.001). Infection of murine osteoblasts deleted for the ?1-integrin resulted in a drastic reduction in the internalization rate. No difference was observed regarding biofilm formation. Conclusions: Surgical management plays a crucial role in outcome of BJI involving corynebacteria, as often chronic and device-associated infections. Sanctuarisation within osteoblasts, implicating the ?1 cellular integrin, may represent a pivotal virulence factor associated with BJI chronicity.
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hal-03556421 , version 1 (04-02-2022)

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Pierre Chauvelot, Tristan Ferry, Virginie Tafani, Alan Diot, Jason Tasse, et al.. Bone and Joint Infection Involving Corynebacterium spp.: From Clinical Features to Pathophysiological Pathways. Frontiers in Medicine, 2021, 7, 13p. ⟨10.3389/fmed.2020.539501⟩. ⟨hal-03556421⟩
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