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Propionibacterium shoulder

Daniel B Buchalter, Siddharth A Mahure, Brent Mollon, Stephen Yu, Young W Kwon, Joseph D Zuckerman
BACKGROUND: Periprosthetic shoulder infections (PSIs) are challenging to treat and often result in significant patient morbidity. Without a standardized treatment protocol, PSIs are often managed similarly to periprosthetic hip and knee infections. Because 2-stage revision is the gold standard for treating periprosthetic hip and knee infections, we performed a case series and literature review to determine its effectiveness in PSIs. METHODS: We identified 19 patients (14 men) from our institution who were treated with a 2-stage revision after presenting with a PSI...
November 22, 2016: Journal of Shoulder and Elbow Surgery
Scott Holmes, Ana M Pena Diaz, George S Athwal, Kenneth J Faber, David B O'Gorman
BACKGROUND: Propionibacterium (P) acnes infection of the shoulder after arthroplasty is a common and serious complication. Current detection methods for P acnes involve anaerobic cultures that require prolonged incubation periods (typically 7-14 days). We have developed a polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) approach that sensitively and specifically identifies P acnes in tissue specimens within a 24-hour period. METHODS: Primers were designed to amplify a unique region of the 16S rRNA gene in P acnes that contained a unique HaeIII restriction enzyme site...
November 22, 2016: Journal of Shoulder and Elbow Surgery
Travis M Falconer, Mohammed Baba, Lisa M Kruse, Oscar Dorrestijn, Matthew J Donaldson, Margaret M Smith, Melanie C Figtree, Bernard J Hudson, Benjamin Cass, Allan A Young
BACKGROUND: Propionibacterium acnes is a common pathogen identified in postoperative shoulder infection. It has been shown to be present in culture specimens during primary shoulder arthroplasty; however, recent work has suggested that it is most likely to be a contaminant. Our aim was to identify the potential sources of contamination in shoulder arthroplasty. METHODS: Tissue swabs were obtained for microbiological analysis from consecutive patients undergoing primary shoulder arthroplasty...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
Travis E Wright, K Keely Boyle, Thomas R Duquin, John K Crane
BACKGROUND: Many studies have noted an increase in the number of recognized cases of invasive infections due to Propionibacterium acnes, especially after shoulder replacement surgery. The increase in the number of recognized cases of P. acnes, a nonspore-forming, anaerobic, Gram-positive organism, appears due to both an increase in the number of shoulder operations being performed and more specimens being sent for anaerobic cultures. Nevertheless, the optimal surgical and antibiotic management of P...
2016: Infectious Diseases
M Daniel Hatch, Stephen D Daniels, Kimberly M Glerum, Laurence D Higgins
BACKGROUND: Increasing methicillin resistance and recognition of Propionibacterium acnes as a cause of infection in shoulder arthroplasty has led to the adoption of local vancomycin powder application as a more effective method to prevent expensive periprosthetic infections. However, no study has analyzed the cost effectiveness of vancomycin powder for preventing infection after shoulder replacement. METHODS: Cost data for infection-related care of 16 patients treated for deep periprosthetic shoulder infection was collected from our institution for the break-even analysis...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Elizabeth M Pinder, Joshua Cy Ong, R Stephen Bale, Ian A Trail
Prosthetic shoulder infection can cause significant morbidity secondary to pain and stiffness. Symptoms may be present for years before diagnosis because clinical signs are often absent and inflammatory markers may be normal. An emerging common culprit, Propionibacterium acnes, is hard to culture and so prolonged incubation is necessary. A negative culture result does not always exclude infection and new synovial fluid biochemical markers such as α defensin are less sensitive than for lower limb arthroplasty...
July 2016: Shoulder & Elbow
Leo Pauzenberger, Annemarie Grieb, Michael Hexel, Brenda Laky, Werner Anderl, Philipp Heuberer
PURPOSE: The primary aim of the present study was to determine the incidence of infections following arthroscopic rotator cuff repair in a single department over a 10-year period. Secondary goals included the evaluation of potential risk factors for infections and to investigate the efficacy of perioperative antibiotic prophylaxis in the reduction of infectious complications. METHODS: A retrospective evaluation of 3294 all-arthroscopic rotator cuff repairs performed between 2004 and 2014 at a single institution was conducted to determine the rate of infection in all-arthroscopic rotator cuff repairs...
June 24, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Jason E Hsu, Roger E Bumgarner, Frederick A Matsen
➤ Propionibacterium is a slow-growing gram-positive rod that is part of the normal skin microbiome but can be found on culture of specimens from a large number of patients having revision shoulder arthroplasty performed for pain, stiffness, and component loosening. ➤ Propionibacterium infections do not present with obvious signs of infection, such as swelling, erythema, drainage, or tenderness, but rather are of the so-called stealth type, presenting with unexplained pain, stiffness, or component loosening months to years after the index arthroplasty...
April 6, 2016: Journal of Bone and Joint Surgery. American Volume
Margaret V Shields, Leath Abdullah, Surena Namdari
BACKGROUND: Propionibacterium acnes is the most common cause of infection after shoulder arthroplasty. Whereas there are several methods that can aid in the diagnosis of P. acnes infection, there is not a single "gold standard" because of the difficulties inherent in identifying this bacterium. We present an evidence-based discussion of the demographic, clinical, and radiographic predictors of P. acnes infection and review the current options for diagnosis. METHODS: This review was written after a comprehensive analysis of the current literature related to shoulder periprosthetic joint infection and P...
June 2016: Journal of Shoulder and Elbow Surgery
Anna Rienmüller, Olivier Borens
BACKGROUND: With improved diagnostic methods and longer prosthesis indwelling time, the frequency of diagnosed Propionibacterium prosthetic joint infections (PJI) is increasing. Data on clinical, microbiological, radiological and surgical treatment are limited, and importance of this organism in PJI is probably underestimated. MATERIALS AND METHODS: We retrospectively analyzed patients with PJI caused by Propionibacterium spp. diagnosed at our institution between 2000 and 2012...
May 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Gregory N Nelson, Daniel E Davis, Surena Namdari
BACKGROUND: Although many case series have been published on the treatment of shoulder periprosthetic joint infection (PJI), few provide direct comparison of outcomes. This systematic review synthesizes the available English literature on shoulder PJI to quantify treatment effectiveness. METHODS: The PubMed and Embase databases were searched in April 2014. Keywords included "shoulder replacement infection" and "shoulder arthroplasty infection." Of 663 titles, 55 manuscripts underwent full-text review after application of exclusion criteria...
August 2016: Journal of Shoulder and Elbow Surgery
Robert M Lucas, Jason E Hsu, Ian J Whitney, Jory Wasserburger, Frederick A Matsen
BACKGROUND: Glenoid loosening is one of the most common causes of total shoulder failure. High rates of positive cultures of Propionibacterium and coagulase-negative staphylococcus have been found among shoulders having surgical revision for glenoid loosening. This study reviewed the culture results in a series of surgical revisions for failed total shoulder arthroplasty to determine the relationship between glenoid loosening and positive cultures. METHODS: The medical records of 221 patients without obvious evidence of infection who underwent revision total shoulder arthroplasty were reviewed to examine the association between the security of fixation of the glenoid component and the results of cultures obtained at revision surgery...
August 2016: Journal of Shoulder and Elbow Surgery
Damani A Piggott, Yvonne M Higgins, Michael T Melia, Brandon Ellis, Karen C Carroll, Edward G McFarland, Paul G Auwaerter
Background.  Prosthetic joint infections (PJIs) significantly complicate joint arthroplasties. Propionibacterium acnes is an increasingly recognized PJI pathogen, yet limited clinical and therapeutic data exist. We sought to examine characteristics of P. acnes shoulder PJIs and compare surgical and nonsurgical management outcomes. Methods.  A retrospective analysis of P. acnes shoulder PJIs was conducted at an academic center in Baltimore, Maryland from 2000 to 2013. Results.  Of 24 cases of P. acnes shoulder PJIs, 92% were diagnosed after extended culture implementation; 42% in the delayed and 46% in the late postsurgical period...
January 2016: Open Forum Infectious Diseases
Simon Marmor, Thomas Bauer, Nicole Desplaces, Beate Heym, Anne-Laure Roux, Olivier Sol, Julie Rogé, Florence Mahé, Laurent Désiré, Philippe Aegerter, Idir Ghout, Jacques Ropers, Jean-Louis Gaillard, Martin Rottman
We developed and evaluated a multiplex antibody detection-based immunoassay for the diagnosis of prosthetic joint infections (PJIs). Sixteen protein antigens from three Staphylococcusspecies (Staphylococcus aureus,Staphylococcus epidermidis, and Staphylococcus lugdunensis) (8 antigens),Streptococcus agalactiae(4 antigens), and Propionibacterium acnes(4 antigens) were selected by comparative immune proteomics using serum samples from PJI cases versus controls. A bead-based multiplex immunoassay that measured serum IgG against purified, recombinant forms of each of the 16 antigens was developed...
April 2016: Journal of Clinical Microbiology
Robert Hudek, Frank Sommer, Ayman F Abdelkawi, Martina Kerwat, Hans-Helge Müller, Frank Gohlke
BACKGROUND: Propionibacterium acnes (P acnes) has been linked to chronic infections in shoulder surgery. It was recently observed during first-time shoulder surgery in healthy patients at a rate between 36% and 56%. Male gender and the anterolateral approach were reported risk factors. Because the skin biology greatly differs, we aimed to correlate skin complaints with P acnes-positive intraoperative cultures from different tissue layer samples in patients undergoing shoulder surgery for the first time...
June 2016: Journal of Shoulder and Elbow Surgery
Chuan Kong Koh, Jonathan P Marsh, Dragana Drinković, Cameron G Walker, Peter C Poon
BACKGROUND: Recent literature has shown that Propionibacterium acnes can be cultured from superficial and deep layers of the shoulder. Our aims were to assess the rate of P. acnes colonization in patients undergoing primary shoulder arthroplasty, to identify patient-related risk factors, and to evaluate the efficacy of our perioperative antisepsis protocol. METHODS: Thirty consecutive patients undergoing primary shoulder arthroplasty were included in our study. Swabs were taken perioperatively (4 superficial and 2 deep wound swabs) and analyzed quantitatively for P...
May 2016: Journal of Shoulder and Elbow Surgery
Daniel J Hackett, Lynn A Crosby
The microbiome of the shoulder demonstrates distinctive differences to other orthopaedic surgical sites. Recent studies have demonstrated that the most common organisms found in deep shoulder infections are coagulase-negative staph lococcal species and Propionibacterium acnes . Many studies support diligent hand washing, decreasing operative time, routine glove changing, minimizing operating room traffic, and covering instruments as means for decreasing the risk of deep infection. On the other hand, hair clipping and the use of adhesive drapes may have little effect on decreasing the incidence of deep infection...
December 2015: Bulletin of the Hospital for Joint Diseases
Benjamin K Kadler, Saurabh S Mehta, Lennard Funk
Propionibacterium acnes has been implicated as a cause of infection following shoulder surgery, may occur up to 2 years after the index operation and has been shown to be responsible for up to 56% of shoulder infections after orthopedic implant. Male patients within the population undergoing shoulder surgery are particularly at risk, especially if their shoulder surgery involved prosthesis or was posttraumatic. P. acnes infection can be difficult to diagnose clinically and laboratory techniques require prolonged and specialized cultures...
October 2015: International Journal of Shoulder Surgery
Jacob D Gorbaty, Robert M Lucas, Frederick A Matsen
PURPOSE: The purpose of this article is to illustrate that the clinical findings of detritic synovitis complicating a total shoulder arthroplasty can strongly resemble those of a 'stealth' periprosthetic shoulder infection with a low-virulence organism such as Propionibacterium. METHODS: We present a review of the literature and illustrate an example of detritic synovitis following a total shoulder arthroplasty. RESULTS: The combination of glenoid component loosening and humeral osteolysis after total shoulder arthroplasty are commonly attributed to periprosthetic infection with low virulence organisms, such as Propionibacterium or coagulase negative Staphylococcus...
January 2016: International Orthopaedics
Joideep Phadnis, David Gordon, Jeganath Krishnan, Gregory Ian Bain
BACKGROUND: In vitro, Propionibacterium acnes (P acnes) is highly susceptible to commonly used antibiotics and antiseptics, yet in vivo, it still causes postsurgical infections of the shoulder. We hypothesized that the local environment within the pilosebaceous glands protects P acnes and that incision of the skin transects these glands, exposing viable P acnes to the wound. METHODS: Fifty consecutive patients undergoing open shoulder surgery were prospectively studied...
February 2016: Journal of Shoulder and Elbow Surgery
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