The role of Staphylococcus aureus small colony variants in intraosseous invasion and colonization in periprosthetic joint infection

• Published in: Bone & joint research Vol. 11; no. 12; pp. 843 - 853
• Main Authors: Cai, Yuanqing, Huang, Changyu, Chen, Xiaoqing, Chen, Yang, Huang, Zida, Zhang, Chaofan, Zhang, Wenming, Fang, Xinyu
• Format: Journal Article
• Language: English
• Published: England British Editorial Society of Bone & Joint Surgery 01.12.2022; The British Editorial Society of Bone & Joint Surgery
• Subjects: Bone (long); Bone and tissue; Chemokines; Colonies; Colonization; Gene expression; Genomes; Immunofluorescence; Infection; intraosseous; Joint diseases; Penicillin; Periprosthetic joint infection; Periprosthetic joint infection (PJI); Polymerase chain reaction; Principal components analysis; Small colony variant; Staphylococcus aureus; Staphylococcus infections; Transcriptomics; Transmission electron microscopy; intraosseous; musculoskeletal infections; pathogenesis; Periprosthetic joint infection; Bone and tissue; Periprosthetic joint infection (PJI); gene expression profiles; electron microscopy; osteoblasts; chemokines; Small colony variant; Staphylococcus aureus
• ISSN: 2046-3758; 2046-3758
• DOI: 10.1302/2046-3758.1112.BJR-2021-0590.R1

This study aimed to explore the role of small colony variants (SCVs) of in intraosseous invasion and colonization in patients with periprosthetic joint infection (PJI). A PJI diagnosis was made according to the MusculoSkeletal Infection Society (MSIS) for PJI. Bone and tissue samples were collected intraoperatively and the intracellular invasion and intraosseous colonization were detected. Transcriptomics of PJI samples were analyzed and verified by polymerase chain reaction (PCR). SCVs can be isolated from samples collected from chronic PJIs intraoperatively. Transmission electron microscopy (TEM) and immunofluorescence (IF) showed that there was more in bone samples collected from chronic PJIs, but much less in bone samples from acute PJIs, providing a potential mechanism of PJI. Immunofluorescence results showed that SCVs of were more likely to invade osteoblasts in vitro. Furthermore, TEM and IF also demonstrated that SCVs of were more likely to invade and colonize in vivo Cluster analysis and principal component analysis (PCA) showed that there were substantial differences in gene expression profiles between chronic and acute PJI. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that these differentially expressed genes were enriched to chemokine-related signal pathways. PCR also verified these results. Our study has shown that the SCVs have a greater ability to invade and colonize in bone, resulting in remaining in bone tissues long-term, thus explaining the pathogenesis of chronic PJI.Cite this article:  2022;11(12):843-853.