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Propionibacterium acnes contamination in lumbar disc surgery
A Carricajo1, C Nuti, E Aubert
1Bacteriology Department, CHU Hospital Bellevue Saint-Etienne, France. anne.carricajo@chu-st.etienne.fr
Abstract:
Previous studies have shown that Propionibacterium acnes may be responsible for low-grade infection of the intervertebral discs of patients with severe sciatica. The aim of this study was to prospectively investigate the presence of bacteria in disc fragment samples obtained during surgery for lumbar disc herniation. P. acnes was cultured from disc fragments in two (3.7%) of 54 patients studied. In addition, control cultures taken from ligamentum flavum and muscle from these two patients were also positive for P. acnes. Similar control cultures were positive for P. acnes from a further ten (18.5%) patients. Four air samples taken during surgery all contained P. acnes; the organism was also found from three of 54 laminar flow control cultures. Sample contamination appears the most likely cause for the presence of P. acnes in the lumbar disc fragment cultures.
Insights
Propionibacterium acnes (P. acnes) was investigated in lumbar disc herniation surgery. The study found P. acnes in patient samples, but contamination is the likely cause, not disc infection.
Area of Science:
- Microbiology
- Neurosurgery
- Orthopedics
Background:
- Propionibacterium acnes (P. acnes) has been implicated in low-grade intervertebral disc infections.
- Sciatica is often associated with severe lumbar disc herniation.
Purpose of the Study:
- To prospectively investigate the presence of bacteria in disc fragments from patients undergoing surgery for lumbar disc herniation.
- To determine if P. acnes is a causative agent in these cases.
Main Methods:
- Disc fragment samples were collected during surgery for lumbar disc herniation.
- Bacterial cultures were performed on disc fragments, ligamentum flavum, muscle, and air samples.
- Laminar flow control cultures were also analyzed.
Main Results:
- P. acnes was cultured from disc fragments in 3.7% of patients.
- P. acnes was also detected in control samples (ligamentum flavum, muscle, air, and laminar flow controls) from multiple patients.
- The high prevalence of P. acnes in control and environmental samples suggests contamination.
Conclusions:
- The presence of P. acnes in lumbar disc fragment cultures is most likely due to sample contamination during surgery.
- This study does not support P. acnes as a primary pathogen in this cohort of lumbar disc herniation patients.
