Propionibacterium acnes colonization of the human shoulder

Patel, Amar; Calfee, Ryan P.; Plante, Matthew; Fischer, Staci A.; Green, Andrew

doi:10.1016/j.jse.2009.01.023

Cited by 261 publications

(141 citation statements)

References 13 publications

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“…This result is consistent with previous observations in the shoulder 10,40,45,46 and in the spine 41 . Propionibacterium usually did not grow on culture of dermal specimens from female subjects whereas dermal cultures were commonly positive for male patients.…”

Section: Discussionsupporting

confidence: 94%

Origin of Propionibacterium in Surgical Wounds and Evidence-Based Approach for Culturing Propionibacterium from Surgical Sites

Matsen

Butler-Wu

Carofino³

et al. 2013

The Journal of Bone & Joint Surgery

146

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Section: Discussionsupporting

confidence: 94%

Origin of Propionibacterium in Surgical Wounds and Evidence-Based Approach for Culturing Propionibacterium from Surgical Sites

Matsen

Butler-Wu

Carofino³

et al. 2013

The Journal of Bone & Joint Surgery

146

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“…There were no positive aerobic culture results; P. acnes decreased by almost 50%; and P. acnes decreased for both male and female patients who had cyanoacrylate microbial sealant applied in this study. Our finding of higher rates of P. acnes in men in this series has been similarly reported in the literature [4,10,15].…”

Section: Discussionsupporting

confidence: 91%

“…Third, we found a higher proportion of male patients were in Group MS compared with Group SP. P. acnes skin colonization [15] and infection [4,10] are more prevalent in men. Because we had more men in Group MS and because men have a higher rate of P. acnes, we would have expected a greater rate of P. acnes-positive cultures in Group MS.…”

Section: Discussionmentioning

confidence: 99%

“…We determined the proportion of positive cultures and rates of confirmed clinical infections in each group using a chi-square analysis to compare the positive culture rates and a two-tailed t-test to compare the average preoperative laboratory values and age between the two groups using IBM SPSS Statistics (IBM Corporation, Armonk, NY, USA). 15]). However, post hoc power analysis revealed a power of 13%.…”

Section: Methodsmentioning

confidence: 99%

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Cyanoacrylate Microbial Sealant May Reduce the Prevalence of Positive Cultures in Revision Shoulder Arthroplasty

Lorenzetti

Wongworawat

Jobe

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Cyanoacrylate-based, microbial sealant is an adhesive skin barrier designed to prevent bacterial contamination in surgical wounds. This type of adhesive barrier could have use in decreasing the incidence of positive cultures and subsequent infection in shoulder arthroplasty. Questions/purposes We therefore evaluated whether cyanoacrylate microbial sealant reduced the positive intraoperative culture rates in revision shoulder arthroplasty. Methods We retrospectively reviewed 55 patients who underwent revision shoulder arthroplasties. Intraoperative aerobic and anaerobic deep tissue culture results taken during the revisions were compared. Cultures were taken of the deep synovial tissue lining the prosthesis. Patients were divided into two groups: those who underwent standard preparations with adhesive, iodine-barrier drapes (Group SP) and those who had placement of cyanoacrylate microbial sealant in addition to the standard prep (Group MS). Results The prevalence of cases with positive cultures was 18% (seven of 40) in Group SP compared with 7% (one of 15) in Group MS. The prevalence of positive, anaerobic Propionibacterium acnes cultures was 13% in Group SP compared with 7% in Group MS. The prevalence of infections confirmed at revision surgery was 8% in Group SP versus 0% in Group MS. Conclusions Our observations suggest application of a cyanoacrylate microbial sealant may reduce the prevalence of positive cultures and thereby subsequent infections in revision shoulder arthroplasties.

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“…As a result, it is found to be responsible for five times more infections in men than in women. 8,9 The rate of skin colonization with P. acnes is high at arthroscopic portals, especially in men. 10 P. acnes is found to be the second germ responsible for infections of the prosthesis of the shoulder after staphylococcus aureus, and has been described in shoulder trauma, open rotator cuff repairs, shoulder instability surgery and shoulder arthroscopy.…”

Section: Discussionmentioning

confidence: 99%

Propionibacterium acnes as a cause of shoulder osteoarthritis after three shoulder arthroscopies: a case report and review of preventive action

et al. 2017

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We report a case of postoperative osteoarthritis infection caused by P. acnes after shoulder arthroscopy, and review possible preventive action. A right-handed 24-year-old man presented an anterior instability of the left shoulder. The patient underwent an anterior stabilization by the latarjet procedure. Stabilization failed, requiring a second and third surgery. The patient returned 10 months later for suspected septic arthritis of his left shoulder. An arthroscopy lavage with bacteriological and anatomo-pathological sampling was carried out. The bacteriological results revealed a positive P. acnes culture. The patient was treated using antibiotherapy for 12 weeks with a combination of clindamicin and moxifloxacin. C-reactive protein (CRP) was negative two months after the onset of antibiotherapy. P. acnes is a anaerobic, non-sporulated, gram-positive bacillus. This commensal germ is part of the normal cutaneous flora and causes acne, but has also been recognized as a causative pathogen in osteoarticular infections since the 1990s, as described by Coden. Treatment is achieved via surgical debridement and intravenous antibiotics. We insist on preventive action in the form of a preoperative patient preparation protocol. Previous literature has underlined the important role of chlorhexidine or alcoholic iodinated polyvidone in the prevention of these infections. As P. acnes is a commensal germ of the patient's skin, prophylaxis should be reinforced by the thorough preparation of the surgery and surgical site. Clindamycin antibioprophylaxy specific to this germ should be administered for this surgery. To my knowledge, there is no specific antibioprophylaxy for shoulder surgery to date.

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Propionibacterium acnes colonization of the human shoulder

Cited by 261 publications

References 13 publications

Origin of Propionibacterium in Surgical Wounds and Evidence-Based Approach for Culturing Propionibacterium from Surgical Sites

Origin of Propionibacterium in Surgical Wounds and Evidence-Based Approach for Culturing Propionibacterium from Surgical Sites

Cyanoacrylate Microbial Sealant May Reduce the Prevalence of Positive Cultures in Revision Shoulder Arthroplasty

Propionibacterium acnes as a cause of shoulder osteoarthritis after three shoulder arthroscopies: a case report and review of preventive action

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