Format

Send to

Choose Destination
J Shoulder Elbow Surg. 2015 Jun;24(6):844-7. doi: 10.1016/j.jse.2014.10.016. Epub 2014 Dec 26.

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

Author information

1
Department of Orthopedics and Sports Medicine, University of Washington, Seattle, WA, USA. Electronic address: matsen@u.washington.edu.
2
Department of Orthopedics, University of Washington, Seattle, WA, USA.
3
Department of Laboratory Medicine, University of Washington Medical Center, Seattle, WA, USA.
4
Department of Medicine, University of Washington Medical Center, Seattle, WA, USA.

Abstract

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.

KEYWORDS:

Propionibacterium; Shoulder arthroplasty; antibiotic prophylaxis; revision

PMID:
25547858
DOI:
10.1016/j.jse.2014.10.016
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center