{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:50:04Z","timestamp":1790607004765,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023670","name":"Nyckelfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023670","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006736","name":"\u00d6rebro University Hospital","doi-asserted-by":"publisher","award":["OLL-502241"],"award-info":[{"award-number":["OLL-502241"]}],"id":[{"id":"10.13039\/501100006736","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and objectives<\/jats:title>\n                  <jats:p>Staphylococcus epidermidis is a major cause of prosthetic joint infections (PJIs). Multidrug resistant (MDR), hospital-adapted clones constitute most cases globally, though regional differences in lineage dissemination likely exist. The aim was to explore the population structure of S. epidermidis from PJIs in Sweden and France, with a focus on the presence of antimicrobial resistance (AMR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study included genome sequence data from 191 clinical S. epidermidis isolates collected from patients with PJI in central Sweden (2007\u201316; n\u200a=\u200a138) and the Lyon region in France (2015\u201320; n\u200a=\u200a53).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Hospital-adapted lineages with a high burden of AMR dominated the cases in both countries. However, the ST2 lineage was significantly more prevalent in Sweden (43% versus 11% in France), while ST5 and ST87 were more common in France (55% versus 10% in Sweden). ST215 was only present in Sweden (25%). A significantly higher prevalence of streptogramin resistance genes [vat(B), vga(A), vga(B)] was found in French (26%) versus Swedish (2%) isolates. These genes were present in all ST87 isolates and in 20% of the French ST5 isolates. The erm(C) gene (resistance to streptogramin A, macrolides and lincosamides) was also more common in the French isolates (77% versus 55% of Swedish isolates), and so was the fusidic acid resistance gene fusB (France: 66%, Sweden: 39%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study highlights significant regional differences in S. epidermidis variants causing PJI. Despite similar MDR levels, certain AMR genes, particularly those related to streptogramin resistance, were significantly more prevalent among French isolates. This suggests that S. epidermidis undergoes local adaptation to region-specific antibiotic usage.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaf166","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T11:21:38Z","timestamp":1748949698000},"page":"2007-2015","source":"Crossref","is-referenced-by-count":4,"title":["Antibiotic resistance and population structure of <i>Staphylococcus epidermidis<\/i> from prosthetic joint infections in Sweden and France"],"prefix":"10.1093","volume":"80","author":[{"given":"Sofie M","family":"Edslev","sequence":"first","affiliation":[{"name":"Department of Sequencing and Bioinformatics, Statens Serum Institut , Copenhagen ,","place":["Denmark"]},{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0609-9091","authenticated-orcid":false,"given":"Frederic","family":"Laurent","sequence":"additional","affiliation":[{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]},{"name":"Service de Bact\u00e9riologie, Centre National de R\u00e9f\u00e9rence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon , Lyon ,","place":["France"]},{"name":"Equipe StaPath, CIRI, Centre International de Recherche en Infectiologie, Universit\u00e9 de Lyon , Lyon ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emeli","family":"M\u00e5nsson","sequence":"additional","affiliation":[{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]},{"name":"Centre for Clinical Research, Region V\u00e4stmanland\u2013Uppsala University, V\u00e4stmanland Hospital V\u00e4ster\u00e5s , V\u00e4ster\u00e5s ,","place":["Sweden"]},{"name":"Department of Medical Sciences, Uppsala University , Uppsala ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thor Bech","family":"Johannesen","sequence":"additional","affiliation":[{"name":"Department of Sequencing and Bioinformatics, Statens Serum Institut , Copenhagen ,","place":["Denmark"]},{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7074-3219","authenticated-orcid":false,"given":"Mia","family":"Aarris","sequence":"additional","affiliation":[{"name":"Department of Sequencing and Bioinformatics, Statens Serum Institut , Copenhagen ,","place":["Denmark"]},{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute Wolff","family":"S\u00f6nksen","sequence":"additional","affiliation":[{"name":"Department of Bacteria, Parasites and Fungi, Statens Serum Institut , Copenhagen ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3716-0521","authenticated-orcid":false,"given":"Camille","family":"Kolenda","sequence":"additional","affiliation":[{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]},{"name":"Service de Bact\u00e9riologie, Centre National de R\u00e9f\u00e9rence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon , Lyon ,","place":["France"]},{"name":"Equipe StaPath, CIRI, Centre International de Recherche en Infectiologie, Universit\u00e9 de Lyon , Lyon ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5939-2932","authenticated-orcid":false,"given":"Bo","family":"S\u00f6derquist","sequence":"additional","affiliation":[{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]},{"name":"Faculty of Medicine and Health, School of Medical Sciences, \u00d6rebro University , \u00d6rebro ,","place":["Sweden"]},{"name":"Department of Laboratory Medicine, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro ,","place":["Sweden"]},{"name":"Department of Orthopedics, Faculty of Medicine and Health, \u00d6rebro University , \u00d6rebro ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Stegger","sequence":"additional","affiliation":[{"name":"Department of Sequencing and Bioinformatics, Statens Serum Institut , Copenhagen ,","place":["Denmark"]},{"name":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Study Group for Staphylococci and Staphylococcal Diseases (ESGS) , Basel ,","place":["Switzerland"]},{"name":"Faculty of Medicine and Health, School of Medical Sciences, \u00d6rebro University , \u00d6rebro ,","place":["Sweden"]},{"name":"Antimicrobial Resistance and Infectious Diseases Laboratory, Harry Butler Institute, Murdoch University , Perth ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"2025070104564774100_dkaf166-B1","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1038\/s41579-022-00780-3","article-title":"Staphylococcus epidermidis and its dual lifestyle in skin health and infection","volume":"21","author":"Severn","year":"2023","journal-title":"Nat Rev Microbiol"},{"key":"2025070104564774100_dkaf166-B2","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1080\/14787210.2021.1967745","article-title":"Novel strategies to diagnose prosthetic or native bone and joint infections","volume":"20","author":"Van Belkum","year":"2022","journal-title":"Expert Rev Anti Infect Ther"},{"key":"2025070104564774100_dkaf166-B3","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1016\/j.diagmicrobio.2019.01.006","article-title":"Microbiology of polymicrobial prosthetic joint infection","volume":"94","author":"Flurin","year":"2019","journal-title":"Diagn Microbiol Infect Dis"},{"key":"2025070104564774100_dkaf166-B4","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.3390\/diagnostics12071654","article-title":"Microbiological profiles of patients with periprosthetic joint infection of the hip or knee","volume":"12","author":"Fr\u00f6schen","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"2025070104564774100_dkaf166-B5","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1186\/s40001-023-01138-y","article-title":"Bacterial pathogens and in-hospital mortality in revision surgery for periprosthetic joint infection of the hip and knee: analysis of 346 patients","volume":"28","author":"Migliorini","year":"2023","journal-title":"Eur J Med Res"},{"key":"2025070104564774100_dkaf166-B6","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.cmi.2018.04.035","article-title":"Microbiologic epidemiology depending on time to occurrence of prosthetic joint infection: a prospective cohort study","volume":"25","author":"Triffault-Fillit","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"2025070104564774100_dkaf166-B7","doi-asserted-by":"publisher","first-page":"2540","DOI":"10.1128\/JB.01484-06","article-title":"Inferring a population structure for Staphylococcus epidermidis from multilocus sequence typing data","volume":"189","author":"Miragaia","year":"2007","journal-title":"J Bacteriol"},{"key":"2025070104564774100_dkaf166-B8","doi-asserted-by":"publisher","first-page":"e0218121","DOI":"10.1128\/spectrum.02181-21","article-title":"Genomics of Staphylococcus aureus and Staphylococcus epidermidis from periprosthetic joint infections and correlation to clinical outcome","volume":"10","author":"Trobos","year":"2022","journal-title":"Microbiol Spectr"},{"key":"2025070104564774100_dkaf166-B9","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.ijmm.2012.11.001","article-title":"Comparison of Staphylococcus epidermidis isolated from prosthetic joint infections and commensal isolates in regard to antibiotic susceptibility, agr type, biofilm production, and epidemiology","volume":"303","author":"Hellmark","year":"2013","journal-title":"Int J Med Microbiol"},{"key":"2025070104564774100_dkaf166-B10","doi-asserted-by":"publisher","first-page":"000504","DOI":"10.1099\/mgen.0.000504","article-title":"Comparative genomics of Staphylococcus epidermidis from prosthetic-joint infections and nares highlights genetic traits associated with antimicrobial resistance, not virulence","volume":"7","author":"M\u00e5nsson","year":"2021","journal-title":"Microb Genom"},{"key":"2025070104564774100_dkaf166-B11","doi-asserted-by":"publisher","first-page":"e1009304","DOI":"10.1371\/journal.ppat.1009304","article-title":"Distinct clonal lineages and within-host diversification shape invasive Staphylococcus epidermidis populations","volume":"17","author":"Both","year":"2021","journal-title":"PLoS Pathog"},{"key":"2025070104564774100_dkaf166-B12","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s10096-021-04352-w","article-title":"Heterogeneity of Staphylococcus epidermidis in prosthetic joint infections: time to reevaluate microbiological criteria?","volume":"41","author":"Widerstr\u00f6m","year":"2022","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"2025070104564774100_dkaf166-B13","doi-asserted-by":"publisher","first-page":"87","DOI":"10.3109\/17453674.2013.773120","article-title":"Bacterial colonization and resistance patterns in 133 patients undergoing a primary hip- or knee replacement in Southern Sweden","volume":"84","author":"Stef\u00e1nsd\u00f3ttir","year":"2013","journal-title":"Acta Orthop"},{"key":"2025070104564774100_dkaf166-B14","author":"ECDC"},{"key":"2025070104564774100_dkaf166-B15","author":"ECDC"},{"key":"2025070104564774100_dkaf166-B16","author":"ECDC"},{"key":"2025070104564774100_dkaf166-B17","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1302\/0301-620X.103B1.BJJ-2020-1381.R1","article-title":"The EBJIS definition of periprosthetic joint infection","volume":"103-b","author":"McNally","year":"2021","journal-title":"Bone Joint J"},{"key":"2025070104564774100_dkaf166-B18","doi-asserted-by":"publisher","first-page":"R46","DOI":"10.1186\/gb-2014-15-3-r46","article-title":"Kraken: ultrafast metagenomic sequence classification using exact alignments","volume":"15","author":"Wood","year":"2014","journal-title":"Genome Biol"},{"key":"2025070104564774100_dkaf166-B19","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1089\/cmb.2012.0021","article-title":"SPAdes: a new genome assembly algorithm and its applications to single-cell sequencing","volume":"19","author":"Bankevich","year":"2012","journal-title":"J Comput Biol"},{"key":"2025070104564774100_dkaf166-B20","doi-asserted-by":"publisher","first-page":"e000074","DOI":"10.1099\/mgen.0.000074","article-title":"NASP: an accurate, rapid method for the identification of SNPs in WGS datasets that supports flexible input and output formats","volume":"2","author":"Sahl","year":"2016","journal-title":"Microb Genom"},{"key":"2025070104564774100_dkaf166-B21","doi-asserted-by":"publisher","first-page":"e15","DOI":"10.1093\/nar\/gku1196","article-title":"Rapid phylogenetic analysis of large samples of recombinant bacterial whole genome sequences using Gubbins","volume":"43","author":"Croucher","year":"2015","journal-title":"Nucleic Acids Res"},{"key":"2025070104564774100_dkaf166-B22","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1093\/molbev\/msu300","article-title":"IQ-TREE: a fast and effective stochastic algorithm for estimating maximum-likelihood phylogenies","volume":"32","author":"Nguyen","year":"2015","journal-title":"Mol Biol Evol"},{"key":"2025070104564774100_dkaf166-B23","doi-asserted-by":"publisher","first-page":"e000131","DOI":"10.1099\/mgen.0.000131","article-title":"ARIBA: rapid antimicrobial resistance genotyping directly from sequencing reads","volume":"3","author":"Hunt","year":"2017","journal-title":"Microb Genom"},{"key":"2025070104564774100_dkaf166-B24","doi-asserted-by":"publisher","first-page":"3491","DOI":"10.1093\/jac\/dkaa345","article-title":"ResFinder 4.0 for predictions of phenotypes from genotypes","volume":"75","author":"Bortolaia","year":"2020","journal-title":"J Antimicrob Chemother"},{"key":"2025070104564774100_dkaf166-B25","doi-asserted-by":"publisher","first-page":"2948","DOI":"10.1093\/jac\/dkae312","article-title":"Probing fosfomycin\u2019s potential: a study on susceptibility testing and resistance in Staphylococcus epidermidis from prosthetic joint infections","volume":"79","author":"Widerstr\u00f6m","year":"2024","journal-title":"J Antimicrob Chemother"},{"key":"2025070104564774100_dkaf166-B26","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-319-24277-4","volume-title":"ggplot2: Elegant Graphics for Data Analysis","author":"Wickham","year":"2016"},{"key":"2025070104564774100_dkaf166-B27","author":"Massicotte"},{"key":"2025070104564774100_dkaf166-B28","author":"Kolde"},{"key":"2025070104564774100_dkaf166-B29","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1093\/jac\/dkaf035","article-title":"rpob mutations and their association with rifampicin resistance in clinical Staphylococcus epidermidis","volume":"80","author":"Edslev","year":"2025","journal-title":"J Antimicrob Chemother"},{"key":"2025070104564774100_dkaf166-B30","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1556\/EuJMI-D-14-00038","article-title":"Review and phylogenetic analysis of qac genes that reduce susceptibility to quaternary ammonium compounds in Staphylococcus species","volume":"5","author":"Wassenaar","year":"2015","journal-title":"Eur J Microbiol Immunol (Bp)"},{"key":"2025070104564774100_dkaf166-B31","doi-asserted-by":"publisher","first-page":"e02607-18","DOI":"10.1128\/AAC.02607-18","article-title":"A novel, widespread qacA allele results in reduced chlorhexidine susceptibility in Staphylococcus epidermidis","volume":"63","author":"Addetia","year":"2019","journal-title":"Antimicrob Agents Chemother"},{"issue":"Suppl 2","key":"2025070104564774100_dkaf166-B32","doi-asserted-by":"publisher","first-page":"ii30","DOI":"10.1093\/jac\/dkab175","article-title":"Consumption of macrolides, lincosamides and streptogramins in the community, European union\/European economic area, 1997\u20132017","volume":"76","author":"Adriaenssens","year":"2021","journal-title":"J Antimicrob Chemother"},{"key":"2025070104564774100_dkaf166-B33","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1080\/14787210.2021.1834851","article-title":"Streptogramins for the treatment of infections caused by Gram-positive pathogens","volume":"19","author":"Reissier","year":"2021","journal-title":"Expert Rev Anti Infect Ther"},{"key":"2025070104564774100_dkaf166-B34","author":"EMA"},{"key":"2025070104564774100_dkaf166-B35","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1016\/S0369-8114(03)00054-3","article-title":"In vitro activity of the pristinamycin against the isolated staphylococci in the French hospitals in 1999\u20132000","volume":"51","author":"Leclercq","year":"2003","journal-title":"Pathol Biol (Paris)"},{"key":"2025070104564774100_dkaf166-B36","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1080\/00365540500491976","article-title":"Staphylococcus aureus resistant to fusidic acid among Swedish children: a follow-up study","volume":"38","author":"Osterlund","year":"2006","journal-title":"Scand J Infect Dis"},{"key":"2025070104564774100_dkaf166-B37","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1080\/00365540903146987","article-title":"Clonality among multidrug-resistant hospital-associated Staphylococcus epidermidis in Northern Europe","volume":"41","author":"Widerstr\u00f6m","year":"2009","journal-title":"Scand J Infect Dis"}],"container-title":["Journal of Antimicrobial Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/80\/7\/2007\/63424512\/dkaf166.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jac\/article-pdf\/80\/7\/2007\/63424512\/dkaf166.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T08:56:55Z","timestamp":1751360215000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jac\/article\/80\/7\/2007\/8155726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,3]]},"references-count":37,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,6,3]]},"published-print":{"date-parts":[[2025,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jac\/dkaf166","relation":{},"ISSN":["0305-7453","1460-2091"],"issn-type":[{"value":"0305-7453","type":"print"},{"value":"1460-2091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,7]]},"published":{"date-parts":[[2025,6,3]]}}}