Comparative genomic analysis of resistance and virulence genes in staphylococcus epidermidis and their impact on clinical outcome of musculoskeletal infections

Abstract Staphylococcus epidermidis is an opportunistic commensal cutaneous biofilm-producing agent frequently causing musculoskeletal infections (MSI) with/without implants. This study was design to evaluate phenotypic and genomic relatedness between commensal skin and MSI S. epidermidis isolates a...

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Main Authors: Ingrid Nayara Marcelino Santos, Felipe Alberto-Lei, Fernanda Fernandes Santos, Mariana Felix Cerqueira Balera, Mariana Neri Kurihara, Carolina Coelho Cunha, Laís Sales Seriacopi, Thomas Stravinskas Durigon, Fernando Baldy Reis, Ana Karolina Antunes Eisen, Giovana Santos Caleiro, Jansen de Araújo, Edison Luiz Durigon, Giselle Burlamaqui Klautau, Mauro José Salles
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-09061-4
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Summary:Abstract Staphylococcus epidermidis is an opportunistic commensal cutaneous biofilm-producing agent frequently causing musculoskeletal infections (MSI) with/without implants. This study was design to evaluate phenotypic and genomic relatedness between commensal skin and MSI S. epidermidis isolates and to assess patient-related and microbial markers in the outcome of patients after one-year follow-up. Demographics, clinical data and monomicrobial S. epidermidis isolates of MSI patients (n = 31) and healthy individuals (n = 15) were analyzed. Phenotypic profile was assessed by susceptibility tests by broth microdilution and biofilm formation. Phylogenetic relationships, resistome characterization, and virulome analysis were carried out by complete genome sequencing (n = 46). Overall, MSI-derived isolates were significantly more strong/moderate biofilm producers and depicted higher rates of resistance to methicillin (MRSE), ciprofloxacin, gentamicin and rifampicin. Demographics and clinical characteristics did not significantly affect MSI patients’ outcomes. In the whole-genomic sequencing (WGS) phylogeny, most MSI-derived isolates were grouped into the pathogenic-associated clonal complex CC2, and significantly higher prevalence of mecA gene and pathogenic marker IS256. Following multivariate analysis, MSI-derived isolates carrying transposable element IS256 are more likely to develop a persistent infection (odds ratio [OR], 8.00, [95% confidence interval (CI), 1.06 to 60.31], P = 0.044), while weaker biofilm producer were protectors (OR, 0.070, 95%CI, 0.005–0.979, P = 0.048), reducing the chance of recurrence by 93% (1–0.070). The logistic regression model’s performance was evaluated by Nagelkerke’s R, which resulted in 47.21%. In conclusion, S. epidermidis isolates producing MSI were phenotypically and genetically distinct from commensals, proven the association between independent genetic traits and patient’s outcome.
ISSN:2045-2322