The Microbiome of Osteoarthritic Hip and Knee Joints: A Prospective Multicenter Investigation.

Autor:	Goswami K; Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., Clarkson S; Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., Tipton C; Department of Biological Sciences, Texas Tech University, Lubbock, Texas., Phillips CD; Department of Biological Sciences, Texas Tech University, Lubbock, Texas., Dennis DA; Colorado Joint Replacement, Denver, Colorado., Klatt BA; Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., O'Malley M; Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Smith EL; New England Baptist Hospital, Chestnut Hill, Massachusetts., Gililland J; Department of Orthopaedics, University of Utah, Salt Lake City, Utah., Pelt CE; Department of Orthopaedics, University of Utah, Salt Lake City, Utah., Peters CL; Department of Orthopaedics, University of Utah, Salt Lake City, Utah., Malkani AL; University of Louisville Adult Reconstruction Program, Louisville, Kentucky., Palumbo BT; University of South Florida Department of Orthopaedic Surgery, Clearwater, Florida., Lyons ST; University of South Florida Department of Orthopaedic Surgery, Clearwater, Florida., Bernasek TL; University of South Florida Department of Orthopaedic Surgery, Clearwater, Florida., Minter J; Northside Hospital, Atlanta, Georgia., Goyal N; Anderson Orthopaedic Research Institute, Alexandria, Virginia., Purtill W; Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., McDonald JF 3rd; Anderson Orthopaedic Research Institute, Alexandria, Virginia., Cross MB; Hospital for Special Surgery, New York, NY., Prieto HA; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, Florida., Lee GC; Penn Presbyterian Medical Center, Philadelphia, Pennsylvania., Hansen EN; University of California San Francisco, San Francisco, California., Bini SA; University of California San Francisco, San Francisco, California., Ward DT; University of California San Francisco, San Francisco, California., Zhao N; Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., Shohat N; Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania., Higuera CA; Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio., Nam D; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Della Valle CJ; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Parvizi J; Rothman Orthopaedic Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Jazyk:	angličtina
Zdroj:	The Journal of bone and joint surgery. American volume [J Bone Joint Surg Am] 2023 May 16. Date of Electronic Publication: 2023 May 16.
DOI:	10.2106/JBJS.22.00594
Abstrakt:	Background: Recent advances in high-throughput DNA sequencing technologies have made it possible to characterize the microbial profile in anatomical sites previously assumed to be sterile. We used this approach to explore the microbial composition within joints of osteoarthritic patients. Methods: This prospective multicenter study recruited 113 patients undergoing hip or knee arthroplasty between 2017 and 2019. Demographics and prior intra-articular injections were noted. Matched synovial fluid, tissue, and swab specimens were obtained and shipped to a centralized laboratory for testing. Following DNA extraction, microbial 16S-rRNA sequencing was performed. Results: Comparisons of paired specimens indicated that each was a comparable measure for microbiological sampling of the joint. Swab specimens were modestly different in bacterial composition from synovial fluid and tissue. The 5 most abundant genera were Escherichia, Cutibacterium, Staphylococcus, Acinetobacter, and Pseudomonas. Although sample size varied, the hospital of origin explained a significant portion (18.5%) of the variance in the microbial composition of the joint, and corticosteroid injection within 6 months before arthroplasty was associated with elevated abundance of several lineages. Conclusions: The findings revealed that prior intra-articular injection and the operative hospital environment may influence the microbial composition of the joint. Furthermore, the most common species observed in this study were not among the most common in previous skin microbiome studies, suggesting that the microbial profiles detected are not likely explained solely by skin contamination. Further research is needed to determine the relationship between the hospital and a "closed" microbiome environment. These findings contribute to establishing the baseline microbial signal and identifying contributing variables in the osteoarthritic joint, which will be valuable as a comparator in the contexts of infection and long-term arthroplasty success. Level of Evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence. Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/H489). (Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated.)
Databáze:	MEDLINE
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