{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:40:43Z","timestamp":1792510843019,"version":"4.5.0"},"reference-count":46,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The aim of this study was to characterize the\n                      <jats:italic toggle=\"yes\">in vivo<\/jats:italic>\n                      evolution of\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      strains involved in recurrent prosthetic joint infections (PJIs) both phenotypically and genomically. We conducted a monocentric retrospective study in a 1,437-bed French teaching hospital between 2013 and 2021. All patients presenting a recurrent\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      -related PJI\u2014defined as at least two strains isolated from distinct clinical samples more than 90 days apart\u2014of the knee, hip, or shoulder were included. Clinical data were reviewed, and all isolates underwent phenotypic characterization, including antimicrobial susceptibility testing, growth rate determination, biofilm production assays, metabolic profiling (API 50 CH), and virulence evaluation using the\n                      <jats:italic toggle=\"yes\">Galleria mellonella<\/jats:italic>\n                      infection model. Whole-genome sequencing (WGS) was performed for all strains, followed by analyses of core-genome multilocus sequence typing (cgMLST), resistome, virulome, and mobilome composition, and single-nucleotide polymorphisms (SNPs). Thirteen patients met inclusion criteria, yielding 55\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      isolates. Eight patients experienced recurrent infections caused by genetically closely related strains throughout the clinical course (median: three strains per patient; range: 2\u20136), whereas five patients were infected by genetically distinct strains. At baseline, isolates were genetically diverse and susceptible to methicillin and rifampicin; two showed fluoroquinolone resistance due to\n                      <jats:italic toggle=\"yes\">grlA<\/jats:italic>\n                      and\/or\n                      <jats:italic toggle=\"yes\">gyrA<\/jats:italic>\n                      mutations. In one patient (patient C), a recurrent isolate acquired an\n                      <jats:italic toggle=\"yes\">rpoB<\/jats:italic>\n                      S486L mutation, conferring rifampicin resistance after rifampicin exposure. Due to the limited sample size, it is difficult to draw definitive conclusions from the phenotypic analyses. This study highlights the adaptive evolution of\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      during chronic PJIs and underscores the need for further research to better understand intra-host dynamics in long-standing infections.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      This study conducted in a 1,437-bed French teaching hospital analyzed the genomic and phenotypic evolution of 55\n                      <jats:italic toggle=\"yes\">Staphylococcus aureus<\/jats:italic>\n                      strains recovered in recurrent PJIs from 13 patients. The first strains showed high genotypic diversity across 12 different sequence types. Among the 13 patients, only eight experienced a true recurrence with the same strain, while five were contaminated with a different strain of\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      , indicating a new infection. Moreover, this study underscores the complex within-host evolution of\n                      <jats:italic toggle=\"yes\">S. aureus<\/jats:italic>\n                      and highlights the phenotypical and genotypical adaptation during chronic infection.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.04225-25","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:00:49Z","timestamp":1789563649000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["In-host adaptation of\n                    <i>Staphylococcus aureus<\/i>\n                    during recurrent prosthetic joint infections: a retrospective longitudinal study"],"prefix":"10.1128","volume":"14","author":[{"given":"Charles","family":"Maurille","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Normandie Univ, UNICAEN, UNIROUEN, CHU de Caen Normandie, INSERM U1311 DynaMicURe","place":["CAEN, France"]},{"id":[{"id":"https:\/\/ror.org\/03bf2nz41","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, Centre Hospitalier du Mans","place":["Le Mans, France"]},{"id":[{"id":"https:\/\/ror.org\/0250ngj72","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Infectious Diseases, CHU Angers","place":["Angers, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3151-4947","authenticated-orcid":true,"given":"Fran\u00e7ois","family":"Gravey","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Bacteriology Service, Normandie Univ, UNICAEN, UNIROUEN, CHU de Caen Normandie, INSERM U1311 DynaMicURe","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5772-5377","authenticated-orcid":true,"given":"Jean-Christophe","family":"Giard","sequence":"additional","affiliation":[{"name":"Normandie Univ, UNICAEN, UNIROUEN, INSERM U1311 DynaMicURe","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Michon","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Normandie Univ, UNICAEN, CHU de CAEN Normandie","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9019-0033","authenticated-orcid":true,"given":"Goulven","family":"Rochcongar","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Normandie Univ, UNICAEN, CHU de CAEN Normandie","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6310-6126","authenticated-orcid":true,"given":"Bertrand","family":"Lecoeur","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, Normandie Univ, UNICAEN, CHU de CAEN Normandie","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6277-5504","authenticated-orcid":true,"given":"Renaud","family":"Verdon","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Normandie Univ, UNICAEN, UNIROUEN, CHU de Caen Normandie, INSERM U1311 DynaMicURe","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7993-4305","authenticated-orcid":true,"given":"Simon","family":"Le Hello","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Bacteriology Service, Normandie Univ, UNICAEN, UNIROUEN, CHU de Caen Normandie, INSERM U1311 DynaMicURe","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2317-2345","authenticated-orcid":true,"given":"Christophe","family":"Isnard","sequence":"additional","affiliation":[{"name":"Department of Infectious Agents, Bacteriology Service, Normandie Univ, UNICAEN, UNIROUEN, CHU de Caen Normandie, INSERM U1311 DynaMicURe","place":["CAEN, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra040181"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis803"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2020.06.022"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00111-13"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-018-9494-z"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.10.3.505"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00134-14"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tim.2016.09.009"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro.2015.13"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/cmi.12582"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11081119"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2018.00018"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25031"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2021.741406"},{"key":"e_1_3_3_16_2","unstructured":"CRIOAC. 2025. Nord-Ouest. Available from: https:\/\/www.crioac.org\/. Retrieved 17 Jun 2025."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.02.078"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.09.044"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200300001-00014"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2023.03.014"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.08.002"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02981-13"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06094-11"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01979-14"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa345"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx217"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.03617-13"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkw387"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e3181123d4e"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12859-016-1016-7"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0167-7012(00)00122-6"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002192"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.05.040"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2011.08.018"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2020198"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(20)30149-X"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2019.00363"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00437-10"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jis772"},{"key":"e_1_3_3_40_2","unstructured":"SPF. 2020. Surveillance de l\u2019antibior\u00e9sistance en \u00e9tablissements de sant\u00e9. Mission Spares. R\u00e9sultats 2020. Available from: https:\/\/www.santepubliquefrance.fr\/import\/surveillance-de-l-antibioresistance-en-etablissements-de-sante.-mission-spares.-resultats-2020. Retrieved 27 May 2022."},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2319"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.6.2295-2297.2004"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.24.5.410"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0092-8674(01)00286-0"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-196810000-00007"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro821"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200064"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.04225-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.04225-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:52:48Z","timestamp":1792507968000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.04225-25"}},"subtitle":[],"editor":[{"given":"Takeaki","family":"Wajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":46,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,6]]}},"alternative-id":["10.1128\/spectrum.04225-25"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.04225-25","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2025-12-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e04225-25"}}