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Small colony variant-producing S aureus prosthesis joint infection highlighted by sonication and treated with prolonged high doses of daptomycin
  1. Camille Piffaut1,
  2. Sébastien Lustig2,3,4,
  3. Frédéric Laurent1,2,4,5,6,
  4. Christian Chidiac2,4,5,7,
  5. Tristan Ferry2,4,5,6,7,
  6. on behalf of the Lyon BJI Study Group
  1. 1Laboratoire de Bactériologie, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
  2. 2Université Claude Bernard Lyon 1, Lyon, France
  3. 3Service de Chirurgie Orthopédique, Centre Albert Trillat, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
  4. 4Centre Interrégional de Référence Rhône-Alpes Auvergne des Infections Ostéo-articulaires complexes, Lyon, France
  5. 5Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de lyon, UCBL1, Lyon, France
  6. 6Centre National de Référence des Staphylocoques, Lyon, France
  7. 7Service de Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
  1. Correspondence to Dr Tristan Ferry, tristan.ferry{at}

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An 80-year-old woman with a history of β-lactam allergy was admitted for chronic knee prosthesis joint infection (PJI) (figure 1A). The prosthesis was removed and sonicated as previously described (400 ml of Ringer solution was added in a sterile box containing the explanted prosthesis, vortexing was performed before and after sonication in ultrasound bath, and then 100 μl of sonicate fluid was plated onto aerobic and anaerobic medium and broth).1 All peroperative samples revealed methicillin-susceptible Staphylococcus aureus in cultures, whereas the sonicate fluid culture yielded additional S aureus small colony variant phenotype (SCV) (figure 1B). …

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