Propionibacterium in Shoulder Arthroplasty: What We Think We Know Today.

➤ Propionibacterium is a slow-growing gram-positive rod that is part of the normal skin microbiome but can be found on culture of specimens from a large number of patients having revision shoulder arthroplasty performed for pain, stiffness, and component loosening. ➤ Propionibacterium infections do...

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Publicado en:Journal of Bone & Joint Surgery, American Volume Vol. 98; no. 7; pp. 597 - 607
Autores principales: Hsu, Jason E., Bumgarner, Roger E., Matsen III, Frederick A., Matsen, Frederick A 3rd
Formato: research Journal Article
Publicado: Lippincott Williams & Wilkins 4/6/2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 4/6/2016
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      pub: Lippincott Williams & Wilkins
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        atl: Propionibacterium in Shoulder Arthroplasty: What We Think We Know Today.
      aug:
        au:
          Hsu, Jason E.
          Bumgarner, Roger E.
          Matsen III, Frederick A.
          Matsen, Frederick A 3rd
        affil: Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington
      sug:
        subj:
          Arthroplasty
          Gram-Positive Bacteria
          Shoulder Joint Surgery
          Actinomycetales Infections Diagnosis
          Biofilms
          Actinomycetales Infections Prevention and Control
          Reoperation
          Human
          Skin Microbiology
          Actinomycetales Infections Immunology
      ab: ➤ Propionibacterium is a slow-growing gram-positive rod that is part of the normal skin microbiome but can be found on culture of specimens from a large number of patients having revision shoulder arthroplasty performed for pain, stiffness, and component loosening. ➤ Propionibacterium infections do not present with obvious signs of infection, such as swelling, erythema, drainage, or tenderness, but rather are of the so-called stealth type, presenting with unexplained pain, stiffness, or component loosening months to years after the index arthroplasty. ➤ Not all propionibacteria are the same: certain subtypes of Propionibacterium are enriched with virulence factors that may enhance deep infection. ➤ Because propionibacteria typically reside in the pilosebaceous glands of the oily skin of the chest and back, standard surgical skin preparation solutions and even perioperative intravenous antibiotics are often inadequate at sterilizing the incision site; therefore, other prophylactic measures such as meticulous implant handling to avoid contact with dermal structures need to be considered. ➤ Recovery of Propionibacterium from the surgical wounds requires that multiple specimens for culture be taken from different areas of the shoulder to reduce sampling error, and cultures should be held for two weeks on multiple culture media. ➤ Future research efforts can be focused on reducing the risk of implant infection and point-of-care methods for identifying Propionibacterium infections.
      pubtype: Academic Journal
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        research
        Journal Article
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    language: English
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