1887

Abstract

is an important cause of bone and joint infections. In recent years, significant changes in the incidence of septic arthritis and osteomyelitis have occurred. Haematogenous osteomyelitis is now less common during childhood, but secondary spread of infection to bone or joint from a contiguous site in adults is increasing in incidence. Infection introduced at the time of surgery or arising by the haematogenous route is a significant complication of prosthetic joint implantation, and the effect of bone cement on local immune function may be important in this setting. Although is a more common cause of prosthetic joint infection, is more difficult to treat. produces a number of extracellular and cell-associated factors, but it is unclear what role these have as virulence factors Furthermore, it is difficult in animal models to simulate transient bacteraemia followed by non-fulminating septic arthritis or osteomyelitis, as occurs in the patient. Surface factors which may be important in pathogenesis include the cell wall (activates complement and stimulates cytokine release), capsular polysaccharide (promotes adhesion to host cell surfaces), collagen receptors and fibronectin-binding protein. Staphylococcal toxic shock syndrome toxin (TSST-1) and the enterotoxins are super-antigens and have the potential to suppress plasma cell differentiation and antibody responsiveness. TSST-1-positive isolates have been shown to cause more severe joint infection in one animal model, but most other studies to date have focused on in-vitro rather than in-vivo effects. There is little evidence supporting a role for coagulase, lipase and the haemolysins in staphylococcal bone and joint infections. Despite the clinical importance of these infections, surprisingly little is known about pathogenesis at the cellular level. Future research should focus on the role of the host immune system in limiting spread of infection, and the expression of virulence factors in animal or other models incorporating isogenic mutant strains.

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1996-03-01
2024-03-29
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References

  1. Waldvogel F. A. Staphylococcus aureus including toxic shock syndrome. In Mandell G. L., Bennett J. E., Dolin R. (eds) Mandell, Douglas and Bennett’s principles and practice of infectious diseases 4th edn, vol 2 New York: Churchill Livingstone; 19951754–1777
    [Google Scholar]
  2. Smith J. W., Piercy E. A. Infectious arthritis. In Mandell G. L., Bennett J. E., Dolin R. (eds) Mandell, Douglas and Bennett’s principles and practice of infectious diseases 4th edn, vol 1 New York: Churchill Livingstone; 19951032–1039
    [Google Scholar]
  3. Mader J. T., Calhoun J. Osteomyelitis. In Mandell G. L., Bennett J. E., Dolin R. (eds) Mandell, Douglas and Bennett’s principles and practice of infectious diseases 4th edn, vol 1 New York: Churchill Livingstone; 19951039–1051
    [Google Scholar]
  4. Cierny G., Mader J. T., Pennick H. A clinical staging system of adult osteomyelitis. Contemp Orthop 1985; 10:17–37
    [Google Scholar]
  5. Dubey L., Krasinski K., Hemanz-Schulman M. Osteomyelitis secondary to trauma or infected contiguous soft tissue. Pediatr Infect Dis J 1988; 7:26–34
    [Google Scholar]
  6. Barton L. L., Dunkle L. M., Habib F. H. Septic arthritis in childhood. A 13-year review. Am J Dis Child 1987; 141:898–900
    [Google Scholar]
  7. Peltola H., Vahvanen V. A comparative study of osteomyelitis and purulent arthritis with special reference to aetiology and recovery. Infection 1984; 12:75–79
    [Google Scholar]
  8. Espersen F., Frimodt-Moller N., Thandrup Rosdahl V., Skinhoj P., Bentzon M. W. Changing pattern of bone and joint infections due to Staphylococcus aureus: study of cases of bacteremia in Denmark: 1959–1988. Rev Infect Dis 1991; 13:347–385
    [Google Scholar]
  9. Craigen M. A. C., Watters J., Hackett J. S. The changing epidemiology of osteomyelitis in children. J Bone Joint Surg [Br] 1992; 74:541–545
    [Google Scholar]
  10. McGuire N. M., Kauffman C. A. Septic arthritis in the elderly. J Am Geriatr Soc 1985; 33:170–174
    [Google Scholar]
  11. Fitzpatrick D. J., Cafferkey M. T., Toner M., Beattie T., Keane C. T. Osteomyelitis with methicillin-resistant Staphylococcus aureus . J Hosp Infect 1986; 8:24–30
    [Google Scholar]
  12. Ish-Horowicz M. R., McIntyre P., Nade S. Bone and joint infections caused by multiply resistant Staphylococcus aureus in a neonatal intensive care unit. Pediatr Infect Dis J 1992; 11:82–87
    [Google Scholar]
  13. Brause B. D. Infections associated with prosthetic joints. Clin Rheumat Dis 1986; 12:523–536
    [Google Scholar]
  14. Wymenga A. B., van Horn J. R., Theeuwes A., Muytjens H. L., Slooff T. J. H. Perioperative factors associated with septic arthritis after arthroplasty. Prospective multicentre study of 362 knee and 2651 hip operations. Acta Orthop Scand 1992; 63:665–671
    [Google Scholar]
  15. Poss R., Thornhill T. S., Ewald F. C., Thomas W. H., Batte N. J., Sledge C. B. Factors influencing the incidence and outcome of infection following total joint arthroplasty. Clin Orthop 1984; 182:117–126
    [Google Scholar]
  16. Petty W. The effect of methylmethacrylate on the bacterial inhibiting properties of normal human serum. Clin Orthop Rel Res 1978; 132:266–278
    [Google Scholar]
  17. Petty W. The effect of methylmethacrylate on bacterial phagocytosis and killing by human polymorphonuclear leukocytes. J Bone Joint Surg (Am) 1978; 60:752–757
    [Google Scholar]
  18. Elek S. D. Staphylococcus pyogenes and its relation to disease. Edinburgh: Livingstone; 1959208
    [Google Scholar]
  19. Lorian V. In vitro simulation of in vivo conditions: physical state of the culture medium. J Clin Microbiol 1989; 27:2403–2406
    [Google Scholar]
  20. Zak O., Sande M. Correlation of in vitro activity of antibiotics in experimental animal models and human infection. In Sabath L. D. (ed) Action of antibiotics in patients Bern: Han Huber Publishers; 198255–67
    [Google Scholar]
  21. Cheung A. L., Fischetti V. A. Variation in the expression of cell wall proteins of Staphylococcus aureus grown on solid and liquid media. Infect Immun 1988; 56:1061–1065
    [Google Scholar]
  22. Clark B. A., Rissing J. P., Buxton T. B., Best N. H., Best G. K. The effect of growth temperature on Staphylococcus aureus binding to type 1 collagen. Microb Pathog 1994; 17:239–251
    [Google Scholar]
  23. Patti J. M., Bremell T., Krajewska-Pietrasik D. The Staphylococcus aureus collagen adhesin is a virulence determinant in experimental septic arthritis. Infect Immun 1994; 62:152–161
    [Google Scholar]
  24. Switalski L. M., Patti J. M., Butcher W., Gristina A. G., Speziale P., Hook M. A collagen receptor on Staphylococcus aureus strains isolated from patients with septic arthritis mediates adhesion to cartilage. Mol Microbiol 1993; 7:99–107
    [Google Scholar]
  25. Foster T. J., McDevitt D. Surface-associated proteins of Staphylococcus aureus: their possible roles in virulence. FEMS Microbiol Lett 1994; 118:199–206
    [Google Scholar]
  26. Vaudaux P., Pittet D., Haeberli A. Fibronectin is more active than fibrin or fibrinogen in promoting Staphylococcus aureus adherence to inserted intravascular catheters. J Infect Dis 1993; 167:633–641
    [Google Scholar]
  27. Gemmell C. G., Tree R., Patel A., O’Reilly M., Foster T. J. Susceptibility to opsonophagocytosis of protein A, alpha-haemolysin and beta-toxin deficient mutants of Staphylococcus aureus isolated by allele replacement. In Jeljaszewicz J., Cibrowski P. (eds) The staphylococci Zentralbl Bakteriol; 1991 Suppl 1 21273–277
    [Google Scholar]
  28. Smith B. G., Johnson H. M. The effect of staphylococcal enterotoxins on the primary in vitro immune response. J Immunol 1975; 115:575–578
    [Google Scholar]
  29. Kunstmann G., Schroder E., Hasbach H., Pulverer G. Immune response to toxic-shock-syndrome toxin-1 (TSST-1) and to staphylococcal enterotoxins A, B and C in Staphylococcus aureus infections. Int J Med Microbiol 1989; 271:486–492
    [Google Scholar]
  30. Sourek J., Výmola F., Trojanová, M., Zelenková, L., Matějovska V., Bergdoll M. S. Enterotoxin production by Staphylococcus aureus strains isolated from cases of chronic osteomyelitis. J Clin Microbiol 1979; 2:266–268
    [Google Scholar]
  31. Fast D. J., Schlievert P. M., Nelson R. D. Nonpurulent response to Toxic Shock Syndrome Toxin 1-producing Staphylococcus aureus: relationship to toxin-stimulated production of Tumour Necrosis Factor. J Immunol 1988; 140:949–953
    [Google Scholar]
  32. Abdelnour A., Bremell T., Holmdahl R., Tarkowski A. Clonal expansion of T lymphocytes causes arthritis and mortality in mice infected with toxic shock syndrome toxin-1-producing staphylococci. Eur J Immunol 1994; 24:1161–1166
    [Google Scholar]
  33. Abdelnour A., Bremell T., Tarkowski A. Toxic shock syndrome toxin-1 contributes to the arthritogenicity of Staphylococcus aureus . J Infect Dis 1994; 170:94–99
    [Google Scholar]
  34. Baddour L. M., Lowrance C., Albus A., Lowrance J. H., Anderson S. K., Lee J. C. Staphylococcus aureus microcapsule expression attenuates bacterial virulence in a rat model of experimental endocarditis. J Infect Dis 1992; 165:749–753
    [Google Scholar]
  35. Jonsson P., Lindberg M., Haraldsson I., Wadström T. Virulence of Staphylococcus aureus in a mouse mastitis model: studies of alpha hemolysin, coagulase, and protein A as possible virulence determinants with protoplast fusion and gene cloning. Infect Immun 1985; 49:765–769
    [Google Scholar]
  36. Bhakdi S., Tranum-Jensen J. Alpha-toxin of Staphylococcus aureus . Microbiol Rev 1991; 55:733–751
    [Google Scholar]
  37. Christensson B., Fehrenbach F. J., Hedström S. A. A new serological assay for Staphylococcus aureus infections: detection of IgG antibodies to S. aureus lipase with an Enzyme-Linked Immunosorbent Assay. J Infect Dis 1985; 152:286–292
    [Google Scholar]
  38. Power M. E., Olson M. E., Domingue P. A. G., Costerton J. W. A rat model of Staphylococcus aureus chronic osteomyelitis that provides a suitable system for studying the human infection. J Med Microbiol 1990; 33:189–198
    [Google Scholar]
  39. Spagnolo N., Greco F., Rossi A., Ciolli L., Teti A., Posteraro P. Chronic staphylococcal osteomyelitis: a new experimental rat model. Infect Immun 1993; 61:5225–5230
    [Google Scholar]
  40. Alderson M., Speers D., Emslie K., Nade S. Acute haematogenous osteomyelitis and septic arthritis — a single disease. J Bone Joint Surg [Br] 1986; 68:268–274
    [Google Scholar]
  41. Bremell T., Lange S., Holmdahl R., Ryden C., Hansson G. K., Tarkowski A. Immunopathological features of rat Staphylococcus aureus arthritis. Infect Immun 1994; 62:2334–2344
    [Google Scholar]
  42. Bone R. C. Gram-positive organisms and sepsis. Arch Int Med 1994; 154:26–34
    [Google Scholar]
  43. Soell M., Diab M., Haan-Archipoff G. Capsular polysaccharide types 5 and 8 of Staphylococcus aureus bind specifically to human epithelial (KB) cells, endothelial cells, and monocytes and induce release of cytokines. Infect Immun 1995; 63:1380–1386
    [Google Scholar]
  44. Williams R. J., Smith R. L., Schurman D. J. Septic arthritis. Staphylococcal induction of chondrocyte proteolytic activity. Arthritis Rheum 1990; 33:533–541
    [Google Scholar]
  45. Bremell T., Lange S., Yacoub A., Rydén C., Tarkowski A. Experimental Staphylococcus aureus arthritis in mice. Infect Immun 1991; 59:2615–2623
    [Google Scholar]
  46. Kuypers J. M., Proctor R. A. Reduced adherence to traumatized rat heart valves by a low-fibronectin-binding mutant of Staphylococcus aureus . Infect Immun 1989; 57:2306–2312
    [Google Scholar]
  47. Arbeit R. D., Karakawa W. W., Vann W. F., Robbins J. B. Predominance of two newly described capsular polysaccharide types among clinical isolates of Staphylococcus aureus . Diagn Microbiol Infect Dis 1984; 2:85–91
    [Google Scholar]
  48. Lee J. C., Takeda S., Livolsi P. J., Paoletti L. C. Effects of in vitro and in vivo growth conditions on expression of type 8 capsular polysaccharide by Staphylococcus aureus . Infect Immun 1993; 61:1853–1858
    [Google Scholar]
  49. Patel A. H., Nowlan P., Weavers E. D., Foster T. Virulence of protein A-deficient and alpha-toxin-deficient mutants of Staphylococcus aureus isolated by allele replacement. Infect Immun 1987; 55:3103–3110
    [Google Scholar]
  50. Schlievert P. M. Role of superantigens in human disease. J Infect Dis 1993; 167:997–1002
    [Google Scholar]
  51. Mills J. T., Dodel A. W., Kass E. H. Regulation of staphylococcal toxic shock syndrome toxin-1 and total exoprotein production by magnesium ion. Infect Immun 1986; 53:663–670
    [Google Scholar]
  52. Phonimdaeng P., O’Reilly M., O’Toole P. W., Foster T. J. Molecular cloning and expression of the coagulase gene of Staphylococcus aureus 8325–4. J Gen Microbiol 1988; 134:75–83
    [Google Scholar]
  53. Taylor A. G., Bernheimer A. W. Further characterization of staphylococcal gamma-hemolysin. Infect Immun 1974; 10:54–59
    [Google Scholar]
  54. Abramson C. Staphylococcal isoenzymes related to disease. Zentralbl Bakteriol Microbiol Hyg 1976 Suppl 151041–1054
    [Google Scholar]
  55. Morrissy R. T., Haynes D. W. Acute haematogenous osteomyelitis: a model with trauma as an etiology. J Pediatr Orthop 1989; 9:447–456
    [Google Scholar]
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