Propionibacterium can be isolated from deep cultures obtained at primary arthroplasty despite intravenous antimicrobial prophylaxis

Matsen, Frederick A.; Russ, Stacy M.; Bertelsen, Alexander; Butler-Wu, Susan M.; Pottinger, Paul S.

doi:10.1016/j.jse.2014.10.016

Cited by 87 publications

(50 citation statements)

References 22 publications

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“…1,8,16,20 P acnes has also been implicated in neurosurgical and ophthalmic infections 17 and is closely linked to the pathogenesis of acne vulgaris because of its high concentration in the pilosebaceous glands of the skin. 11 Some authors have suggested that P acnes is associated with the development of glenohumeral arthritis and adhesive capsulitis, 4,12,17 although this notion has been recently challenged.…”

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confidence: 99%

Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics

Phadnis

Gordon

Krishnan

et al. 2016

Journal of Shoulder and Elbow Surgery

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confidence: 99%

Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics

Phadnis

Gordon

Krishnan

et al. 2016

Journal of Shoulder and Elbow Surgery

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“…P. acnes were found in 24% of shoulders undergoing revision arthroscopy for various reasons [9], and the same organism were isolated from deep tissue culture specimens obtained during open shoulder surgery [20], even despite timely antibiotic administration [19]. Male gender and younger age seem to predispose towards P. acnes colonization [13].…”

Section: Discussionmentioning

confidence: 99%

High incidence of periprosthetic joint infection with propionibacterium acnes after the use of a stemless shoulder prosthesis with metaphyseal screw fixation - a retrospective cohort study of 241 patients propionibacter infections after eclipse TSA

Johansson

Hailer

Rahme

2017

BMC Musculoskelet Disord

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BackgroundA stemless shoulder prosthesis with humeral metaphyseal screw fixation was introduced in order to save bone-stock and to facilitate reconstruction of biomechanics (Eclipse®). The aim of this study was to analyze whether the risk of infection is different with this implant compared to conventional shoulder prosthesis.MethodsTwo hundred and forty-one patients (54.8% females) were operated with a shoulder arthroplasty and followed for median 2.0 (0.1–5.7) years. One hundred and two (42.3%) had received an Eclipse® prosthesis, the remaining patients were operated with other implants. There was an overrepresentation of males in the Eclipse® group (63.7% males) when compared with the control group (31.7% males).ResultsIn the Eclipse® group 10 (9.8%) patients developed a periprosthetic joint infection, as opposed to 1 (0.7%) in the control group. The most common bacteria was Propionibacterium acnes. Unadjusted infection-free survival after 4 years was 88.8% (CI 82.5–95.7) for Eclipse® patients and 95.7% (CI 87.7–100.0) for controls (p = 0.002). After adjustment for age, gender, diagnosis, and type of shoulder prosthesis (total or hemi), the risk ratio for revision due to infection was 4.3 (CI 0.5–39.1) for patients with the Eclipse® prosthesis.ConclusionsDeep infections seem to be more common after the use of the metaphyseally fixed Eclipse® prosthesis than after conventional shoulder implants, but a predominance of male gender and younger age in the Eclipse group may have biased our findings. Future studies on larger cohorts and in vitro investigations on bacterial adherence and biofilm formation are needed.Trial registrationThe study was conducted in accordance with the Helsinki Declaration. The local ethics board (Regionala Etikprövningsnämnden Stockholm) approved the study (Approval number 2015/1590–31, date of issue 2015-10-14). Retrospectively registered.

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“…C. acnes colonizes hair follicles and sebaceous glands found around the shoulder . Current preoperative preparations have been ineffective at C. acnes eradication, which increases the risk of deep joint tissue infections during shoulder procedures …”

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confidence: 99%

“…[1][2][3][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Current preoperative preparations have been ineffective at C. acnes eradication, 24,25 which increases the risk of deep joint tissue infections during shoulder procedures. [25][26][27] Numerous strategies have been reported for the prevention of SSI in open shoulder surgery. Despite this, there is a general non-scientific approach to the prevention of infection in shoulder surgery, and recent studies have documented the variability in surgeon treatment and prevention methods.…”

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confidence: 99%

Exploring Penicillin G as an Intrawound Antibiotic Powder for Prevention of Postoperative Shoulder Infections: Does It Exhibit In Vitro Chondrotoxicity?

Nadig

Shaw

Parada

2019

Journal Orthopaedic Research

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Cutibacterium acnes (C. acnes) is a significant insidious pathogen for postoperative infections in shoulder surgery. Studies have demonstrated that certain topical antibiotic powders used have the potential for chondrotoxicity. Benzylpenicillin, commonly referred to as Penicillin G (Pen G) has the lowest minimum inhibitory concentration (MIC) for C. acnes. There is no research regarding the topical application of Pen G during shoulder surgery, nor has its chondrocyte toxicity been previously investigated. This study sought to characterize the in vitro chondrocyte toxicity of Pen G. Culture‐derived bovine chondrocytes were exposed to serial Pen G concentrations and compared with a positive and negative control. A negative control of growth medium and positive control of 1% Triton solution. The chondrocyte viability was assessed via spectrophotometer absorbance. The treatment groups were analyzed using one‐way repeated measures analysis of variance and Pearson's correlation analysis. The chondrocyte viability was significantly higher for all Pen G concentrations as compared with the positive control (p < 0.001). All concentrations of Pen G exhibited continued chondrocyte metabolic activity over time. Analysis of variance, independent of time, demonstrated no significant decrease in chondrocyte viability for Pen G concentrations ≤6.25 mg/ml, as compared with the negative control (p > 0.05). Pen G demonstrated a significant negative correlation with its concentration and absorbance (r = 0.371, p < 0.001), however, concentrations ≤6.25 mg/ml did not demonstrate a significant decrease in chondrocyte viability (p = 0.063). Pen G in concentrations appropriate for C. acnes is not significantly chondrotoxic and may be safe for intrawound application. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:726‐730, 2020

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Propionibacterium can be isolated from deep cultures obtained at primary arthroplasty despite intravenous antimicrobial prophylaxis

Cited by 87 publications

References 22 publications

Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics

Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics

High incidence of periprosthetic joint infection with propionibacterium acnes after the use of a stemless shoulder prosthesis with metaphyseal screw fixation - a retrospective cohort study of 241 patients propionibacter infections after eclipse TSA

Exploring Penicillin G as an Intrawound Antibiotic Powder for Prevention of Postoperative Shoulder Infections: Does It Exhibit In Vitro Chondrotoxicity?

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