Infections ostéo-articulaires à staphylocoques

Bone and joint infections (BJIs) are mainly caused by staphylococci. High rates of treatment failure and long-term functional sequelae in BJI patients have been associated to bone loss and frequent relapses or chronicization of the infection. In this review, we summarize recent findings that helped improve our understanding of BJI pathophysiology. The main points include : (1) the interactions of S. aureus with bone and immune cells, and how these interactions disrupt the homeostasis of the bone tissue and lead to bone damage ; (2) how staphylococci adapt to chronic infection through the establishment of biofilms, the invasion of bone cells and the so-called phenotype switching phenomenon, three mechanisms that can have important consequences on the diagnosis and management of BJIs ; and (3) peculiar forms of acute and destructive BJIs caused by some S. aureus isolates able to secrete the necrotic toxin Panton-Valentine leukocidin.