Cutibacterium acnes infections in revision surgery for persistent shoulder complaints: a retrospective cohort study

Pruijn, Nathalie; Diek, Floor M. van; Meis, Jacques F.; Kosse, Nienke M.; Dorrestijn, Oscar

doi:10.1007/s00402-020-03415-5

Cited by 7 publications

(3 citation statements)

References 32 publications

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“…The improvements in biomaterials design for articular cartilage repair prefigure a larger use in implantology for the close future, with a potential increase in the number of septic complications.This evidence was recently reviewed by Bauer et al which reported that the introduction of implants and transplants was probably the main reason of a 3-fold increase of infections (0.14-2.25%) in comparison with the data published previously (Bauer et al, 2015). Moreover, recent findings suggested also that low-grade infections might play a role, as it came to light recently for Cutibacterium acnes infection in shoulder surgery (Pruijn et al, 2020).…”

Section: Introductionmentioning

confidence: 81%

Evaluation of Nisin and LL-37 Antimicrobial Peptides as Tool to Preserve Articular Cartilage Healing in a Septic Environment

Najmi

Kumar

Scalia

et al. 2020

Front. Bioeng. Biotechnol.

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Section: Introductionmentioning

confidence: 81%

Evaluation of Nisin and LL-37 Antimicrobial Peptides as Tool to Preserve Articular Cartilage Healing in a Septic Environment

Najmi

Kumar

Scalia

et al. 2020

Front. Bioeng. Biotechnol.

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“…Because of the lack of cultures obtained during revision surgery, the incidence is very likely underestimated. 21 Unfortunately, these data were not presented for group 1 in the study by Lee et al 5 In our experience, low-grade shoulder infection can be a reason for failure and poor outcomes after cuff repair.…”

Section: See Related Article On Page 2080mentioning

confidence: 77%

Editorial Commentary: Rotator Cuff Tear: Know When Not to Operate So You Don't Make It Worse

Heerspink

Dorrestijn²

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Shoulder rotator cuff repair results in significantly improved outcomes compared with conservative treatment, but some repairs result in retear and, worst of all, enlarged retears (i.e., tears larger after surgery than primarily). Elevated serum total cholesterol and low-density lipoprotein levels and fatty infiltration of the infraspinatus are significantly related to symptomatic failed rotator cuff repair. Hypertension could also be a risk factor. In such cases, nonoperative treatment, reverse shoulder prosthesis (in older patients), or alternative joint-preserving procedures (superior capsular reconstruction, subacromial balloon spacer, multiple-tendon interposition autografts, augmentation of the long head of the biceps, or tendon transfers such as latissimus dorsi transfer and lower trapezius transfer) could be considered or are worthy of future investigation.

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“…Shifflet and colleagues [27] found positive intraoperative cultures in presumed aseptic revisions of the spine in 20% of cases, and Shiban et al [6] in 42% of the cases with loosened screws against 18% in non-loosened screws. The high incidence of C. acnes infection in our cohort may be due to the young population studied, having a higher rate of C. acnes colonization compared to older adults [28][29][30].…”

Section: Discussionmentioning

confidence: 87%

A high prevalence of Cutibacterium acnes infections in scoliosis revision surgery, a diagnostic and therapeutic dilemma

et al. 2022

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Purpose To investigate if serum inflammatory markers or nuclear imaging can accurately diagnose a chronic spinal instrumentation infection (SII) prior to surgery. Methods All patients who underwent revision of spinal instrumentation after a scoliosis correction between 2017 and 2019, were retrospectively evaluated. The diagnostic accuracy of serum C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG–PET/CT) and Technetium-99m-methylene diphosphonate (99mTc-MDP) 3-phase bone scintigraphy (TPBS) to diagnose infection were studied. Patients with an acute infection or inadequate culture sampling were excluded. SII was diagnosed if ≥ 2 of the same microorganism(s) were isolated from intra-operative tissue cultures. Results 30 patients were included. The indication for revision surgery was pseudoarthrosis in the majority of patients (n = 15). 22 patients (73%) were diagnosed with SII. In all infected cases, Cutibacterium acnes was isolated, including 5 cases with a polymicrobial infection. The majority of patients had low inflammatory parameters preoperatively. For CRP > 10.0 mg/L, the sensitivity was 9.1% and specificity 100%; for ESR > 30 mm/h, the sensitivity was 9.1% and specificity 100%. The diagnostic accuracy for nuclear imaging was 64% for the FDG–PET/CT and 67% for the TPBS to diagnose infection. Conclusions The prevalence of SII in patients undergoing revision spinal surgery is high, with Cutibacterium acnes as the main pathogen. No diagnostic tests could be identified that could accurately diagnose or exclude SII prior to surgery. Future studies should aim to find more sensitive diagnostic modalities to detect low-grade inflammation.

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Cutibacterium acnes infections in revision surgery for persistent shoulder complaints: a retrospective cohort study

Cited by 7 publications

References 32 publications

Evaluation of Nisin and LL-37 Antimicrobial Peptides as Tool to Preserve Articular Cartilage Healing in a Septic Environment

Evaluation of Nisin and LL-37 Antimicrobial Peptides as Tool to Preserve Articular Cartilage Healing in a Septic Environment

Editorial Commentary: Rotator Cuff Tear: Know When Not to Operate So You Don't Make It Worse

A high prevalence of Cutibacterium acnes infections in scoliosis revision surgery, a diagnostic and therapeutic dilemma

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