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RFL - Revue francophone des laboratoires
Volume 2016, n° 480
pages 33-40 (mars 2016)
Doi : 10.1016/S1773-035X(16)30085-5
Infections ostéo-articulaires à staphylocoques
Staphylococcal bone and joint infections
 

Jean-Philippe Rasigade a, b, , Sophie Trouillet-Assant a, Frédéric Laurent a, b
a INSERM U1111, Centre International de Recherche en Infectiologie, Université Lyon 1 
b Laboratoire de Bactériologie, Centre Hospitalier Lyon-Sud, Chemin du Grand Revoyet - 69495 Pierre-Bénite, Hospices Civils de Lyon 

*Correspondance.
Résumé

Les infections ostéo-articulaires (IOA), majoritairement causées par Staphylococcus spp., sont grevées d’un risque élevé d’échec thérapeutique et de morbidité à long terme. Ce risque a été associé à une importante destruction osseuse et une évolution fréquente vers la chronicité ou la récidive. Dans ce travail, nous proposons une synthèse des récentes avancées dans la compréhension physiopathologique des IOA staphylococciques. Nous décrivons : (1) comment certaines interactions entre S. aureus , le système immunitaire et les cellules de l’os déséquilibrent l’homéostasie du tissu osseux et aboutissent à une perte osseuse ; (2) les mécanismes d’adaptation des staphylocoques à l’infection chronique comme la vie en biofilm, la survie intracellulaire et le ralentissement métabolique, ainsi que leurs conséquences diagnostiques et thérapeutiques ; et (3) les particularités des IOA aiguës et destructrices liées à la synthèse d’une toxine nécrotique, la leucocidine de Panton-Valentine, par certains isolats de S. aureus .

The full text of this article is available in PDF format.
Summary

Bone and joint infections (BJIs) are mainly caused by staphylococci. High rates of treatment failure and long-term functional sequelae in BJI patients have been associated to bone loss and frequent relapses or chronicization of the infection. In this review, we summarize recent findings that helped improve our understanding of BJI pathophysiology. The main points include : (1) the interactions of S. aureus with bone and immune cells, and how these interactions disrupt the homeostasis of the bone tissue and lead to bone damage ; (2) how staphylococci adapt to chronic infection through the establishment of biofilms, the invasion of bone cells and the so-called phenotype switching phenomenon, three mechanisms that can have important consequences on the diagnosis and management of BJIs ; and (3) peculiar forms of acute and destructive BJIs caused by some S. aureus isolates able to secrete the necrotic toxin Panton-Valentine leukocidin.

The full text of this article is available in PDF format.

Mots-clés : Infections ostéo-articulaires, ostéomyélite, arthrite, Staphylococcus aureus , internalisation bactérienne, leucocidine de Panton-Valentine, small colony variant , biofilm

Keyword : Bone and joint infections, osteomyelitis, arthritis, Staphylococcus aureu , bacterial internalization, Panton-Valentine leukocidin, small colony variant, biofilm




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