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Background  Nonsynonymous single nucleotide polymorphisms (SNPs) in fibronectin binding protein A ( fnbA ) of  Staphylococcus aureus  are associated with cardiac device infections. However, the role of  fnbA  SNPs in  S .  aureus  arthroplasty infection is unknown.    Methods  Bloodstream  S .  aureus  isolates from a derivation cohort of patients at a single U.S. medical center with  S .  aureus  bacteremia (SAB) and prosthetic hip or knee arthroplasties that were infected (PJI, n = 27) or uninfected (PJU, n = 43) underwent sequencing of  fnbA  and  fnbB . A validation cohort of  S .  aureus  bloodstream PJI ( n  = 12) and PJU ( n  = 58) isolates from Germany also underwent  fnbA  and  fnbB  sequencing.    Results  Overall, none of the individual  fnbA  or  fnbB  SNPs were significantly associated with the PJI or PJU clinical groups within the derivation cohort. Similarly, none of the individual  fnbA  or  fnbB  SNPs were associated with PJI or PJU when the analysis was restricted to patients with either early SAB (i.e., bacteremia occurring <1 year after placement or manipulation of prostheses) or late SAB (i.e., bacteremia >1 year after placement or manipulation of prostheses).    Conclusions  In contrast to cardiac device infections, there is no association between nonsynonymous SNPs in  fnbA  or  fnbB  of bloodstream  S .  aureus  isolates and arthroplasty infection. These results suggest that initial steps leading to  S .  aureus  infection of cardiovascular and orthopedic prostheses may arise by distinct processes.

Polymorphisms in Fibronectin Binding Proteins A and B among Staphylococcus aureus Bloodstream Isolates Are Not Associated with Arthroplasty Infection