Identification of Propionibacterium avidum from a breast abscess: an overlooked etiology of clinically significant infections

Abstract

We report the case of a 37-year-old previously healthy woman diagnosed with a breast abscess due to Propionibacterium avidum after breast reduction surgery. This case emphasizes the potential pathogenicity and morbidity associated with this commensal skin organism.

Corynebacterium kroppenstedtii in granulomatous mastitis: Analysis of formalin‐fixed, paraffin‐embedded biopsy specimens by immunostaining using low‐specificity bacterial antisera and real‐time polymerase chain reaction

“…Reportedly, Pac infection may cause sarcoidosis that involves epithelioid granuloma formation . It has been reported that Propionibacterium avidum , amplified in case 20 suffering from MA in the present series, causes mammary abscess . Microbacterium sp., another bacterium detected in MA (case 22), has been isolated from human material .…”

“…33 It has been reported that Propionibacterium avidum, amplified in case 20 suffering from MA in the present series, causes mammary abscess. 34 Microbacterium sp., another bacterium detected in MA (case 22), has been isolated from human material. 35 Regarding Pac, however, positive results were frequently observed in the real-time PCR analysis using the Pac-specific primer set.…”

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

“…In the first case, the only predisposing factor was surgery (165). Later, the same case was described by two teams, from Switzerland and Austria, revealing the role of this common skin colonizer, which is well known as a resident of the pilosebaceous follicle unit (15,17). The strain was the only etiology of an ulceration of the inframammary region with induration and putrid secretion.…”

“…Other Gram-positive pathogens are able to produce lipase, such as bacteria of the Burkholderia cepacia complex, with an impact in lung epithelial cell invasion (61), and Candida parapsilosis, a skin commensal for which lipase modulates the immune response of macrophages (62). Future studies clearly need to be performed to investigate the pathogenesis of C. avidum infection, especially in liponecrotic breast abscess or skin necrosis (15)(16)(17)32).…”

“…Although often defined as a commensal (12,13), C. avidum has likely been underestimated, unrecognized, and misidentified in more than a few clinical cases. Despite its low frequency in human infections, numerous associated or invasive infections have been reported: bone infections, infective endocarditis (IE), breast infections, abdominal infections, prostate infections, and splenic and skin abscesses have been described, sometimes with significant collateral damage for the patient (14)(15)(16)(17). In my experience, although one cannot avoid bias according to the identification method used and the awareness of microbiologists, there has been a clearly observed increase in C. avidum-positive samples over the past years.…”