Article entitled: ¿staphylococcus saccharolyticus associated with prosthetic joint infections: clinical features and genomic characteristics¿ by bo söderquist, mastaneh afshar, anja poehlein, and holger brüggemann, published by pathogens 2021, 10, 397, was reviewed.The article investigated five competitor hips that were revised having presented as ¿aseptic¿ implant loosening, but following routine intraoperative specimen collections, determined to be chronic, insidious, low-grade prosthetic joint infections¿the organism being staphylococcus saccharolyticus¿a member of normal skin flora.The article also presented two depuy acute shoulder arthroplasty infections, infected with staphylococcus saccharolyticus and cutibacterium acnes (both identified through routine intraop specimens collected).The article brings to light that staphylococcus saccharolyticus has the potential to cause prosthetic joint infections that can present insidiously as aseptic implant loosening.For purposes of this complaint, only the shoulders will be addressed.Patient 6, a (b)(6) year-old male, initially received a depuy global fx shoulder hemiarthroplasty in 2012, to treat a complicated, proximal humerus traumatic shoulder fracture.At day 17 after primary surgery, presented with pain, swelling, and local inflammation of the shoulder.On day 21, polymicrobial staphylococcus saccharolyticus was grown in 5 of 5 of collected intraop specimens, and cutibacterium acnes was grown in 4 of 5.Patient was prescribed penicillin v for 4 months, and ultimately revised 1 month post-operatively (no revision details provided).It was also reported that one year later, the patient experienced poor functional status, with rom limited to 30 degrees, although the infection was determined to be cured.Patient 7, a (b)(6) year-old male, received a depuy global unite total shoulder arthroplasty to address secondary native septic arthritis of the shoulder that was caused by staphylococcus aureus osteomyelitis.It had been treated for three months with penicillin, and then a year after completion of treatment of the infection, received the total shoulder arthroplasty to address the secondary arthritis.The patient was started on clindamycin immediately post-op, and later replaced with penicillin v for an additional 3 months.Intraop specimens ultimately grew staphylococcus saccharolyticus in 3 of 5 of collected intraop specimens, and cutibacterium acnes was grown in 1 of 5.Upon discontinuation of the antibiotics, patient presented with increased pain in the shoulder, although inflammatory marker crp labs remained low at <4mg/l.Additional surgical tissue biopsies collected later in a second procedure, grew staphylococcus saccharolyticus in 2 of 6, and cutibacterium acnes in 1 of 6 of collected specimens.Shoulder was then treated with amoxicillin, and one month later, a complete explantation of the shoulder prosthesis was performed.All tissue biopsies obtained in that surgical procedure showed no growth.Treatment with amoxicillin was given for three months.A shoulder prosthesis was reimplanted five months after extraction of the infected prosthetic devices.Perioperative cultures at that operation showed no growth.A follow-up after a year showed good functional status of the shoulder.With respect to both primary shoulder prosthesis, no cement manufacturer was identified.The humeral stem interface was also unidentified in both accounts.The manufacturer of the revision products was not identified in either case following treatment of the infections.
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