Pro-inflammatory secreted virulence factors of Staphylococcus capitis causing a rare occurrence of severe native hip joint infection

Patrick M. Schlievert; Samuel H. Kilgore; Bradley Ford; Donald Y. M. Leung; Poorani Sekar

doi:10.1128/asmcr.00067-24

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Pro-inflammatory secreted virulence factors of Staphylococcus capitis causing a rare occurrence of severe native hip joint infection

Journal article

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Pro-inflammatory secreted virulence factors of Staphylococcus capitis causing a rare occurrence of severe native hip joint infection

Patrick M. Schlievert, Samuel H. Kilgore, Bradley Ford, Donald Y. M. Leung and Poorani Sekar

ASM Case Reports, Vol.1(2), e00067-24

03/04/2025

DOI: 10.1128/asmcr.00067-24

PMCID: PMC12530238

PMID: 41244318

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Abstract

Background Staphylococcus capitis occasionally causes human infections. We report a case of S. capitis infection associated with inflammatory destructive hip abscess/osteomyelitis. Case Summary A 63-year-old man with severe hip osteoarthritis and recent left hip replacement presented with 2 months of worsening right hip pain. Radiographic imaging showed right femoral head destruction. The patient had no known hip trauma. His white blood cell count, C-reactive protein, and erythrocyte sedimentation rate were abnormal. Pre-operative aspirate of the hip showed purulent fluid. The examining radiologist believed the changes seen were due to inflammatory arthritis with infection from low-virulence organisms. The patient underwent image-guided biopsies of the synovium and the acetabulum, which showed pure cultures of S. capitis and infiltrating neutrophils. The patient’s native hip was removed, and an antibiotic spacer was placed. The patient was treated with intravenous cefazolin (6 weeks), after which he was transitioned to oral cefadroxil. The patient is doing well. The S. capitis was analyzed by nucleotide sequencing and biochemically for secreted virulence factors. The strain contained the polysaccharide intercellular adhesin biofilm operon. The strain was negative for urease, hemolysins, and major superantigens. The organism secreted a neutrophil pro-inflammatory autolysin protease and an analog of the immunodominant antigen B of S. aureus, previously with no known biological function. Conclusion Our data suggest that the inflammatory lesion in the patient’s right hip was due to S. capitis subspecies capitis, and furthermore, it is likely that two secreted proteins (autolysin and an analog of immunodominant antigen B) contributed to the inflammation.

Details

Title: Subtitle: Pro-inflammatory secreted virulence factors of Staphylococcus capitis causing a rare occurrence of severe native hip joint infection
Creators: Patrick M. Schlievert - University of Iowa
Samuel H. Kilgore - University of Iowa
Bradley Ford - University of Iowa, Pathology
Donald Y. M. Leung - National Jewish Health
Poorani Sekar - University of Iowa
Resource Type: Journal article
Publication Details: ASM Case Reports, Vol.1(2), e00067-24
DOI: 10.1128/asmcr.00067-24
PMID: 41244318
PMCID: PMC12530238
NLM abbreviation: ASM Case Rep
ISSN: 2996-2684
eISSN: 2996-2684
Language: English
Electronic publication date: 02/11/2025
Date published: 03/04/2025
Academic Unit: Microbiology and Immunology; Infectious Diseases; Pathology; Internal Medicine
Record Identifier: 9984790972802771

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