Characteristics and Treatment Outcomes of Propionibacterium acnes prosthetic shoulder infections in adults

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Abstract

Background. Prosthetic joint infections (PJIs) significantly complicate joint arthroplasties. Propionibacterium acnes is an increasinglyrecognized PJI pathogen, yet limited clinical and therapeutic data exist. We sought to examine characteristics of P. acnes shoulder PJIs and compare surgical and nonsurgical management outcomes.Methods. A retrospective analysis of P. acnes shoulder PJIs was conducted at an academic center in Baltimore, Maryland from2000 to 2013.Results. Of 24 cases of P. acnes shoulder PJIs, 92% were diagnosed after extended culture implementation; 42% in the delayedand 46% in the late postsurgical period. Joint pain and diminished function were the predominant presenting clinical signs. Erythrocytesedimentation rate and C-reactive protein elevations occurred in 47% and 44%, respectively. All tested isolates were susceptibleto ß-lactams, moxifloxacin, vancomycin, and rifampin. Clindamycin resistance was identified in 6%. Of the antibiotic-only treatedcases, 67% had a favorable clinical outcome compared with 71% (P = 1.0) of cases with a combined antibiotic-surgical approach. Favorable outcome with and without rifampin therapy was 73% and 60% (P = .61), respectively.Conclusions. Propionibacterium acnes PJI diagnoses increased with extended culture. Inflammatory markers were elevated in aminority of cases. Isolates maintained broad antimicrobial susceptibility. Compared to combined antibiotic-surgical approaches, antibiotic-only approaches were similarly successful in selected cases.

Original languageEnglish (US)
Article numberofv191
JournalOpen Forum Infectious Diseases
Volume3
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

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Keywords

  • Antimicrobial susceptibility
  • Propionibacterium acnes
  • prosthetic joint infection
  • shoulder prosthesis

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

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