Correlation between hemolytic profile and phylotype of Cutibacterium acnes (formerly Propionibacterium acnes) and orthopedic implant infection

Author:

Lee Julia1,Greenwood Quaintance Kerryl E1,Schuetz Audrey N1,Shukla Dave R1,Cofield Robert H1,Sperling John W1,Patel Robin1,Sanchez-Sotelo Joaquin1ORCID

Affiliation:

1. Mayo Clinic, Rochester, USA

Abstract

Introduction Cutibacterium acnes is a recognized culprit for implant-associated infections, but positive cultures do not always indicate clinically relevant infection. Studies have shown a correlation between the β-hemolytic phenotype of C. acnes and its infectious capacity, but correlation with genetic phylotype has not been performed in literature. The purpose of this study is to evaluate β-hemolysis phenotype, genetic phylotype, and mid-term clinical outcomes of C. acnes isolated from orthopedic surgical sites. Methods Fifty-four C. acnes isolates previously obtained from surgical wounds of patients undergoing hip, knee, shoulder, or spine implant removal were re-cultured. There were 21 females and 33 males with an average age of 59 years (range, 18–84). Twenty-four were from clinically infected sites whereas 30 were considered contaminants. De novo β-hemolysis was analyzed and a retrospective chart review was performed to evaluate clinical outcomes at 7.1 years (range, 0.1–12.8). Results On Brucella agar with 5% rabbit blood, 46% of contaminant and 43% of infectious isolates were hemolytic. Type II phylotype was significantly more nonhemolytic regardless of infectious or contaminant status (p < 0.05). Type 1B correlated with a hemolytic-infectious phenotype and Type 1A with a hemolytic-contaminant phenotype but was not statistically significant. Conclusion The β-hemolytic profile of C. acnes did not correlate with phylotype or clinically relevant orthopedic infection.

Publisher

SAGE Publications

Subject

Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine,Surgery

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