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J Infect. 2007 Aug;55(2):119-24. Epub 2007 Apr 5.

Propionibacterium acnes: an agent of prosthetic joint infection and colonization.

Author information

1
Service d'Orthop├ędie et de Traumatologie, Groupe Hospitalier Diaconesses-Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France. vzeller@hopital-dcss.org

Abstract

BACKGROUND:

Prosthetic joint infection (PJI) can present a diagnostic challenge, especially with slow-growing and poorly virulent bacteria.

OBJECTIVE:

To describe the epidemiological, clinical and biological characteristics of Propionibacterium acnes PJI, their treatments and outcomes and compare 2 clinical pictures (according to the time PJI symptoms appeared after the index operation: < or = 2 years, > 2 years).

METHODS:

We conducted a cohort study on P. acnes PJI. Diagnosis was based on > or = 2 positive cultures of intraoperative specimens taken during revision arthroplasties for infection or presumed aseptic loosening.

RESULTS:

Fifty patients with prosthetic hip (34), knee (10) or shoulder (6) infections were included and analyzed according to their symptom-free interval: < or = 2 years for 35 and > 2 years for 15 (mean interval: 11+/-6 years). The numbers of previous prostheses (p=0.04) were higher for the shorter-interval group, which had more frequent signs of infection (p=0.004). These findings suggest infection in most of the patients whose PJI symptoms appeared: < or = 2 years after the index operation, and colonization in the majority of those whose symptoms appeared > 2 years after index surgery. Treatment combining exchange arthroplasty with prolonged intravenous antibiotics was successful for 92% of the patients.

CONCLUSION:

P. acnes can cause different types of PJI: late chronic infections, colonization of loosened prostheses and, exceptionally, acute postoperative infections.

PMID:
17418419
DOI:
10.1016/j.jinf.2007.02.006
[Indexed for MEDLINE]

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