Cutibacterium (Formerly Propionibacterium ) avidum : A Rare but Avid Agent of Prosthetic Hip Infection

Zeller, Valérie; Letembet, Valérie-Anne; Meyssonnier, Vanina; Heym, Béate; Ziza, Jean-Marc; Marmor, Simon

doi:10.1016/j.arth.2018.02.008

Cited by 25 publications

(29 citation statements)

References 21 publications

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“…Therefore it is not surprising that majority of C . avidum infections in our cohort occurred after hip replacement, as recently shown in several reports focusing on infections after hip arthroplasty [ 43 – 45 ]. In line with previous reports, we noted significantly higher positivity rate of diagnostic tests for infections caused by C. avidum with 100% for elevated CRP, synovial fluid leukocyte count and periprosthetic tissue histopathology.…”

Section: Discussionsupporting

confidence: 77%

Orthopedic implant-associated infections caused by Cutibacterium spp. – A remaining diagnostic challenge

et al. 2018

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BackgroundThe definition criteria and clinical characteristics of implant-associated infection (IAI) caused by Cutibacterium (formerly Propionibacterium) spp. are poorly known. We analyzed microbiologically proven Cutibacterium orthopedic IAI in a prospective cohort.MethodsPatients with periprosthetic joint infections (PJI) and fixation device–associated infections (FDAI) caused by Cutibacterium spp. were prospectively included. IAI was defined by significant growth of Cutibacterium spp. and presence of at least one non-microbiological criterion for infection. The McNemar’s chi-squared or binomial test was used to compare the performance of diagnostic tests.ResultsOf 121 patients with Cutibacterium IAI, 62 patients (51%) had PJI and 59 (49%) had FDAI. 109 infections (90%) were caused by C. acnes and 12 (10%) by C. avidum. The median time from implantation until diagnosis of infection was 15.7 months (interquartile range, 5–46.5 months). Clinical local signs were present in 30 patients (28%) and radiological implant loosening in 64 patients (63%). Culture sensitivity of sonication fluid was 84%, of peri-implant tissue 84% and of synovial or peri-implant fluid 56% after 14 days of incubation.ConclusionCutibacterium IAI was diagnosed late in the disease course and presented with subtle signs. Prolonged culture incubation and implant sonication improved the poor performance of conventional microbiological tests. Due to lack of reliable diagnostic tests, Cutibacterium remains difficult to detect making the diagnosis challenging.

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Section: Discussionsupporting

confidence: 77%

Orthopedic implant-associated infections caused by Cutibacterium spp. – A remaining diagnostic challenge

et al. 2018

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“…In general, we found a C. avidum colonization rate of 32.3% in the surgical field of hip arthroplasties. Thus far, skin colonization has been mainly described with C. acnes but not C. avidum, which reflects the current knowledge of mainly C. acnes PJIs [3,[16][17][18] and only three publications so far describing C. avidum PJIs [11,[19][20][21]. Furthermore, skin microbiome data showed skin colonization of C. acnes but not of C. avidum.…”

Section: Discussionmentioning

confidence: 74%

Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection

Böni

Kuster

Bartik

et al. 2018

Clinical Infectious Diseases

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“…Nevertheless, in the event of a high BMI with skin folds, the growth and development of C. avidum near the surgical wound can lead to contiguous inoculation of this uncommon bacterium. A potential association with the anterior surgical approach, which has been performed in recent years, has been mentioned (183). This observation was also reported by Achermann et al, but without any proof (72).…”

Section: Bone and Joint Infectionsmentioning

confidence: 58%

“…Interestingly, and recently in my experience, it has been observed that C. avidum can be involved in shoulder prosthesis infection, probably leading to a chronic status (years) according to its ability to resist antibiotics and to evade the immune system. Henceforth, C. avidum should clearly be considered a virulent pathogen causing, in particular, hip prosthesis infection (after hip arthroplasty surgery using an anterior surgical approach) in obese patients (risk factor), with pain and wound secretion (183). Treatment combining one-stage exchange with prolonged antibiotic therapy allows a favorable outcome.…”

Section: Bone and Joint Infectionsmentioning

confidence: 99%

“…Thus, antibiotics were given for 3 months for the DAIR approach as well as one-stage exchange and for 6 weeks for two-stage exchange (72). Zeller et al reported a similar approach with either clindamycin or cefazolin combined with rifampin administered for 12 weeks after a one-stage exchange for 11 chronic C. avidum hip infections (183). According to these experiences, the DAIR approach seems to be linked to poor outcomes, whereas combining a one-stage surgical approach with prolonged antibiotic treatment allows favorable outcomes.…”

Section: Antibiotic Treatmentmentioning

confidence: 99%

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Clinical and Biological Features of Cutibacterium (Formerly Propionibacterium)avidum, an Underrecognized Microorganism

Corvec

2018

Clin Microbiol Rev

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The recent description of the genus has altered the taxonomy of species. These organisms still belong to the genera of the skin coryneform group, and the most-studied species remains . is also a known skin commensal. This underrecognized microorganism can, however, act as a pathogen after bacterial seeding and can be considered opportunistic, causing either superficial or deep/invasive infections. It can cause numerous infections, including but not limited to breast infections, skin abscesses, infective endocarditis, and device-related infections. The ecological niche of is clearly different from that of other members of the genus: it is found in the axillary region or at wet sites rather than in dry, exposed areas, and the number of microorganisms increases during puberty. Historically, it has been used for its ability to modulate the immune response and for its antitumor properties. Conventional microbial culture methods and identification processes allow for its accurate identification and characterization. Thanks to the modern omics tools used for phylogenomic approaches, understanding pathogenesis (including host-bacterium interactions and virulence factor characterization) is becoming easier, allowing for more thorough molecular characterization. These analyses have revealed that causes diverse diseases mediated by multiple virulence factors. The recent genome approach has revealed specific genomic regions within this species that are involved in adherence and biofilm formation as well as fitness, survival, and defense functions. Numerous regions show the presence of phages and horizontal gene transfer. remains highly sensitive to a broad spectrum of antibiotics, such as β-lactams, fluoroquinolones, macrolides, and rifampin, although erythromycin and clindamycin resistance has been described. A long-term treatment regimen with a combination of antibiotics is required to successfully eliminate the remaining adherent bacteria, particularly in the case of deep infections after debridement surgery.

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Cutibacterium (Formerly Propionibacterium ) avidum : A Rare but Avid Agent of Prosthetic Hip Infection

Cited by 25 publications

References 21 publications

Orthopedic implant-associated infections caused by Cutibacterium spp. – A remaining diagnostic challenge

Orthopedic implant-associated infections caused by Cutibacterium spp. – A remaining diagnostic challenge

Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection

Clinical and Biological Features of Cutibacterium (Formerly Propionibacterium)avidum, an Underrecognized Microorganism

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