High Prophage Count in Staphylococcus Periprosthetic Joint Infection Is Associated With an Increase in Antibiotic Resistance Genes.

Abstract

Periprosthetic joint infections (PJI) caused by Staphylococcus species present a significant clinical challenge, especially in the context of rising antibiotic resistance. Lysogenic phages (viruses that infect bacteria and can integrate into the bacteria's genome in the form of a prophage) have the potential to contribute to antibiotic resistance and treatment failure through the transport of genetic material between bacteria. We hypothesized that prophage presence may be associated with the presence of antimicrobial resistance genes and phenotypic resistance in Staphylococcus species associated with PJI. We examined the relationship between the presence of prophage and antibiotic resistance in Staphylococcus isolates collected from synovial fluid samples from 15 PJI patients. Bacterial isolates were assessed for antibiotic resistance and sequenced to identify prophages and antibiotic resistance genes. We observed that a higher prophage count was associated with a higher number of antibiotic resistance genes, but not with phenotypic antibiotic resistance. In addition, none of the prophages identified were significantly associated with phenotypic resistance. These findings suggest that prophages may contribute to the spread of antibiotic resistance genes, but the impact on phenotypic resistance may be more complex, highlighting the need for further research to explore prophage profiling in PJI biofilms.