Detection of Cutibacterium (Propionibacterium) acnes in orthopaedic surgery: serious problem or contamination?

• Published in: International orthopaedics 2024-02, Vol.48 (2), p.337-344
• Main Authors: Otto-Lambertz, Christina, Yagdiran, Ayla, Boschert, Alessa Lalinka, Eysel, Peer, Walker, Sarah Victoria
• Format: Article
• Language: English
• Subjects: Arthritis, Infectious - surgery; Gram-Positive Bacterial Infections - diagnosis; Gram-Positive Bacterial Infections - epidemiology; Gram-Positive Bacterial Infections - microbiology; Humans; Medicine; Medicine & Public Health; Original Paper; Orthopedic Procedures - adverse effects; Orthopedics; Propionibacterium acnes; Retrospective Studies; Shoulder Joint - surgery; Skin - microbiology
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-023-05981-w

Purpose Bone and joint infections are an important and increasing problem. Whether intraoperatively detected bacteria should be considered relevant or not is often difficult to assess. This retrospective cohort study analyzes the relevance of C. acnes cultured from deep intraoperative specimens. Methods All deep tissue samples collected intraoperatively between 2015 and 2020 from a quartiary care provider were evaluated for detection of C. acnes and its therapeutical consequences. Infection rates were determined according to a standardized definition and protocol and analyzed in dependence of patient’s demographic data (age and gender), operative parameters (type of surgery, body region/location of surgery, and impression of the surgeon), and initiated therapy. Results In 270 cases of more than 8500 samples, C. acnes was detected. In 30%, the detection was considered an infection. The number of samples taken and tested positive for C. acnes correlated significantly with its classification as a cause of infection. If more than one sample of the patient was positive, the detection was significantly more likely to be treated as infection ( p