Multiple hypervirulent methicillin-sensitive Staphylococcus aureus lineages contribute towards poor patient outcomes in orthopedic device-related infections

Staphylococcus aureus is a prominent cause of orthopedic device-associated infections, yet little is known about how the infecting pathogen, and specifically the repertoire ofwith its range of genome-encoded virulence factors, that can impact treatment outcome. Past studies have focused on distinguishing commensal from invasive S. aureus isolates but in this study we aim to investigate traits in infecting isolates that influence patient outcomes. Invasive S. aureus isolates were collected from orthopedic-device related infection patients and categorized according to the success of subsequent treatment ("cured" /"not cured"), as determined following hospital discharge two years after initial presentation. Several MSSA hypervirulent clones were associated with a "not cured" clinical outcome. Improved understanding of the bacterial traits associated with treatment failure in ODRI will inform the risk assessment, prognosis, and therapy of these infections.

金黄色葡萄球菌（Staphylococcus aureus）是骨科植入物相关感染（Orthopedic Device-Related Infection, ODRI）的主要致病菌，但目前对于该感染病原体——尤其是其基因组编码的毒力因子谱——如何影响治疗结局的认知仍十分有限。既往研究多聚焦于区分共生性与侵袭性金黄色葡萄球菌分离株，而本研究旨在探究影响患者预后的感染分离株相关特征。本研究收集了骨科植入物相关感染患者的侵袭性金黄色葡萄球菌分离株，并根据初始就诊后2年出院时评估的后续治疗结局（"治愈"/"未治愈"）进行分类。多株甲氧西林敏感金黄色葡萄球菌（Methicillin-Susceptible Staphylococcus aureus, MSSA）高毒力克隆株与"未治愈"的临床结局显著相关。加深对骨科植入物相关感染中与治疗失败相关的细菌特征的认知，将为此类感染的风险评估、预后判断及治疗方案制定提供科学支撑。