Cutibacterium (formerly Propionibacterium) acnes infections associated with implantable devices

Abstract

Cutibacterium acnes (C. acnes), a Gram-positive biofilm-forming rod implicated in acne vulgaris, is increasingly recognized for its role in implant-associated infections. The diagnosis of C. acnes implant-associated infections remains challenging. The optimal treatment is a combination of both surgical intervention and antibiotic therapy. Areas covered: In this review, we discuss the different types of implant-associated infections caused by C. acnes. We also highlight the clinical manifestations pertaining to the various sites of infection, and identify several risk factors previously reported in the literature. We then cover the diagnostic laboratory markers, such as IL-6 and AD-1, optimizing C. acnes recovery in culture, and the specific molecular techniques. Finally, we examine the various effective antibiotic regimens and identify some preventive methods against C. acnes infections. Expert commentary: Biomarkers such as IL-6 and AD-1 should be further investigated for the diagnosis of C. acnes implant-associated infections. The use of 16S rRNA gene sequencing and other molecular techniques should be further explored in this setting. Longer incubation periods should be requested whenever C. acnes infection is suspected. If the clinical suspicion is high, sonication of the excised implant should be encouraged. Research should focus on developing effective anti-biofilm agents. Finally, preventive methods such as hair removal prior to surgery should be further explored.

Short chain fatty acids produced by Cutibacterium acnes inhibit biofilm formation by Staphylococcus epidermidis

“…Other commensal skin commensal organisms such as specific strains of CoNS can kill S. aureus 18,19 or selectively inhibit the growth of C. acnes 20 but limited information has been found to suggest that C. acnes can benefit its host. In contrast, although typically present without deleterious effect, C. acnes can cause infection of implanted medical devices 21 , and is most frequently thought of due to its involvement in the pathogenesis of acne vulgaris 22,23 . This study sought to determine if C. acnes could benefit it's host by influencing the function of S. epidermidis to form a biofilm.…”

Cardiac Tamponade Caused by Cutibacterium acnes: An Updated and Comprehensive Review of the Literature

“…Chest X-ray might reveal cardiomegaly, pleural effusion, pulmonary infiltrates, or mediastinal widening. On EKG, diffuse ST elevation and PR depression may only occasionally be present [2][3][4][5][6]31]. Although TTE cannot distinguish between inflammatory effusions and purulent fluid collections, it can facilitate the detection and quantification of fluid.…”

Cutibacterium acnes Biofilm Study during Bone Cells Interaction

“…In recent years, Cutibacterium acnes has been increasingly reported as one of the most frequently isolated pathogens in deep tissue infection, complicating shoulder surgery [ 2 , 21 ]. This commensal microbiota can somehow induce BPIs distant-time to the implantation surgery.…”

“…Indeed, genetic modification or a punctual mutation could modify the expression of adhesins and so the strain pathogenicity, leading to the transformation of commensal C. acnes into pathogens [ 30 ]. Therefore, interleukins and chemokines production, reflecting inflammatory processes, will have to be measured to comprehend the bone cells response [ 21 ]. These findings are essential to enhance the prevention and the management of the orthopedic implant-associated infections.…”