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

Background Propionibacterium organisms are commonly recovered from deep cultures obtained at the time of revision arthroplasty. This study sought to determine whether deep cultures obtained at the time of primary arthroplasty can be substantially positive for Propionibacterium despite thorough skin...

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Bibliographic Details
Published in:Journal of shoulder and elbow surgery 2015-06, Vol.24 (6), p.844-847
Main Authors: Matsen, Frederick A., MD, Russ, Stacy M, Bertelsen, Alexander, PAC, Butler-Wu, Susan, PhD, Pottinger, Paul S., MD
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - administration & dosage
Antibiotic Prophylaxis
Arthroplasty, Replacement
Dermis - microbiology
Fascia - microbiology
Humans
Male
Middle Aged
Orthopedics
Osteoarthritis - microbiology
Osteoarthritis - surgery
Propionibacterium
Propionibacterium - isolation & purification
Prosthesis-Related Infections - microbiology
revision
Risk Factors
Shoulder arthroplasty
Shoulder Joint - microbiology
Shoulder Joint - surgery
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Summary:Background Propionibacterium organisms are commonly recovered from deep cultures obtained at the time of revision arthroplasty. This study sought to determine whether deep cultures obtained at the time of primary arthroplasty can be substantially positive for Propionibacterium despite thorough skin preparation and preoperative intravenous antibiotic prophylaxis. Methods After timely administration of preoperative antibiotics chosen specifically for their activity against Propionibacterium and after double skin preparation, specimens from the dermis, fascia, capsule, synovium, and glenoid tissue were sterilely harvested from 10 male patients undergoing primary shoulder arthroplasty and were submitted for culture for Propionibacterium. Results Of the 50 specimens, 7 were positive for Propionibacterium : 3 in each of 2 patients and 1 in 1 patient. The specimen sources having positive anaerobic cultures were the dermis (1 of 10), fascia (2 of 10), synovium (1 of 10), and glenoid tissue (3 of 10). None of these patients had evidence of infection at the time of the arthroplasty. Discussion and Conclusion Preoperative antibiotics and skin preparation do not always eliminate Propionibacterium from the surgical field of primary shoulder arthroplasty. The presence of these bacteria in the arthroplasty wound may pose a risk of delayed shoulder arthroplasty failure from the subtle type of periprosthetic infection typically associated with Propionibacterium.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2014.10.016