Dataset Information

Propionibacterium acnes Host Inflammatory Response During Periprosthetic Infection Is Joint Specific.

ABSTRACT:

Background

Propionibacterium acnes (P. acnes) has become increasingly recognized as a cause of periprosthetic joint infection (PJI).

Questions/purposes

It is not currently known if the clinical presentation of P. acnes varies depending on the joint being infected.

Methods

We retrospectively reviewed patients infected with P. acnes after total hip, knee, and shoulder arthroplasty from two institutions. Patients were classified as having a PJI based on the Musculoskeletal Infection Society criteria and were excluded if they had a polymicrobial culture. Patient demographics, preoperative laboratory values, and microbiology data were analyzed.

Results

Eighteen knees, 12 hips, and 35 shoulders with a P. acnes PJI were identified. Median ESR was significantly higher in the knee (38.0 mm/h, IQR 18.0-58.0) and hip (33.5 mm/h, IQR 15.3-60.0) groups compared to the shoulder group (11.0 mm/h, IQR 4.5-30.5). C-reactive protein levels were higher in the knee (2.0 mg/dl, IQR 1.3-8.9) and hip (2.4 mg/dl, IQR 0.8-4.9) groups compared to the shoulder group (0.7 mg/dl, IQR 0.6-1.5). Median synovial fluid WBC was significantly higher in the knee group than shoulder group (19,950 cells/mm³, IQR 482-60,063 vs 750 cells/mm³, IQR 0-2825, respectively). Peripheral blood WBC levels were similar between groups, as was mean time of P. acnes growth in culture. Clindamycin resistance was present in all groups.

Conclusion

The manner in which a patient with P. acnes PJI presents is joint specific. Inflammatory markers were significantly higher in the knee and hip groups compared to the hip and shoulder groups, and long hold anaerobic cultures up to 14 days are necessary to accurately identify this organism.

SUBMITTER: Nodzo SR

PROVIDER: S-EPMC5481257 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Publications

<b><i>Propionibacterium acnes</i></b> Host Inflammatory Response During Periprosthetic Infection Is Joint Specific.

Nodzo Scott R SR Boyle K Keely KK Bhimani Samrath S Duquin Thomas R TR Miller Andy O AO Westrich Geoffrey H GH

HSS journal : the musculoskeletal journal of Hospital for Special Surgery 20160929 2

<h4>Background</h4><i>Propionibacterium acnes</i> (<i>P. acnes</i>) has become increasingly recognized as a cause of periprosthetic joint infection (PJI).<h4>Questions/purposes</h4>It is not currently known if the clinical presentation of <i>P. acnes</i> varies depending on the joint being infected.<h4>Methods</h4>We retrospectively reviewed patients infected with <i>P. acnes</i> after total hip, knee, and shoulder arthroplasty from two institutions. Patients were classified as having a PJI base ...[more]

PMID: 28690466

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