{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T10:24:14Z","timestamp":1778495054148,"version":"3.51.4"},"reference-count":27,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T00:00:00Z","timestamp":1741651200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Canadian Government | Canadian Institutes of Health Research","award":["PJT-166050"],"award-info":[{"award-number":["PJT-166050"]}]},{"name":"Canadian Government | Canadian Institutes of Health Research","award":["PJT-168842"],"award-info":[{"award-number":["PJT-168842"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Infect Immun"],"published-print":{"date-parts":[[2025,3,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              <jats:italic>Staphylococcus aureus<\/jats:italic>\n              is a predominant cause of post-operative surgical site infections and persistent bacteremia. Here, we describe a patient who experienced three episodes of\n              <jats:italic>S. aureus<\/jats:italic>\n              infection over a period of 4 months following a total knee arthroplasty. The initial bloodstream isolate (SAB-0429) was a clonal complex 5 (CC5) and methicillin-resistant\n              <jats:italic>S. aureus<\/jats:italic>\n              (MRSA), whereas two subsequent isolates (SAB-0485 and SAB-0495) were CC5 isolates but methicillin-sensitive\n              <jats:italic>S. aureus<\/jats:italic>\n              . The two latter isolates harbored a plasmid encoding three superantigen genes that were not present in the primary MRSA isolate. SAB-0485 and SAB-0495 both expressed the plasmid-encoded staphylococcal enterotoxin R exotoxin and demonstrated increased superantigen activity compared with SAB-0429. Compared to SAB-0429, the latter isolates also demonstrated an increased bacterial burden in a mouse bacteremia model that was dependent on increased interferon-\u03b3 production. Curing of the plasmid from SAB-0485 reduced this virulence phenotype. These findings suggest that the superantigen exotoxins may provide a selective advantage in chronic post-surgical infections.\n            <\/jats:p>\n            <jats:sec>\n              <jats:title>IMPORTANCE<\/jats:title>\n              <jats:p>\n                In this study, we investigated bacterial isolates from a patient who experienced three recurrent\n                <jats:italic>S. aureus<\/jats:italic>\n                infections over a 4 month period following total knee arthroplasty. Genomic and phenotypic characterization of these isolates revealed that they all belonged to clonal complex 5, yet the latter two strains contained an additional plasmid encoding superantigen exotoxins. Subsequent experimental infection experiments in mice demonstrated that the plasmid-encoded superantigens exacerbated bacteremia by promoting liver abscess formation. These experiments suggest that despite appropriate antibiotic therapy, bacterial superantigens may be able to promote persistent infection following post-surgery.\n              <\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/iai.00407-24","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T14:04:32Z","timestamp":1738159472000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Evidence that staphylococcal superantigens promote within-patient bacterial persistence following post-operative surgical site infection"],"prefix":"10.1128","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9423-2037","authenticated-orcid":false,"given":"Karine","family":"Dufresne","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2874-7822","authenticated-orcid":true,"given":"Stephen W.","family":"Tuffs","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, Canada"]},{"name":"Department of Biochemistry and Microbiology, University of Victoria","place":["Victoria, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas R.","family":"Walton","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine J.","family":"Kasper","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivor","family":"Mohorovic","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farah","family":"Hasan","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey","family":"Bentall","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Medicine, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7217-2456","authenticated-orcid":true,"given":"David E.","family":"Heinrichs","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Delport","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Western Ontario","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina S.","family":"Mele","sequence":"additional","affiliation":[{"name":"Division of Critical Care Medicine, Department of Medicine, University of Western Ontario","place":["London, Canada"]},{"name":"Division of General Surgery, Department of Surgery, London Health Sciences Centre, University Hospital","place":["London, Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3742-7289","authenticated-orcid":true,"given":"John K.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, University of Western Ontario","place":["London, 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