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Published on: January 7, 2019
Species of Propionibacterium and Propionibacterium acnes phylotypes associated with orthopedic implants
Marta Fernandez Sampedro1, Kerryl E Piper, Andrew McDowell
1Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Abstract:
Propionibacterium sp. is commonly isolated in association with orthopedic implants, either as a pathogen or a colonizer. Microbial characteristics that indicate whether the isolated species is a likely cause of orthopedic implant infection versus a colonizing agent would be clinically useful. We performed a prospective trial to determine the species of Propionibacterium and the phylotype (IA, IB, II, III) of Propionibacterium acnes isolated from the surface of removed orthopedic implants, and we correlated these findings with the presence or absence of infection. P. acnes represented 61 of 62 isolates. P. acnes type I was more commonly isolated than was type II (62% versus 38%, respectively), whether associated with infection or not. P. acnes type III was not detected. There was no clear association between types I and II P. acnes and infection or colonization of failed orthopedic implants (P = 0.75), however type IB strains were more frequently isolated than type IA from infected prosthese.
Insights
Propionibacterium acnes (P. acnes) is frequently found on orthopedic implants. This study found no clear link between P. acnes types I and II and implant infection, though type IB was more common in infected prostheses.
Area of Science:
- Microbiology
- Orthopedic Surgery
- Infectious Diseases
Background:
- Propionibacterium species are frequently isolated from orthopedic implants.
- Distinguishing between pathogenic and colonizing Propionibacterium is clinically important.
- Propionibacterium acnes is the most common species found in these settings.
Purpose of the Study:
- To identify Propionibacterium species and phylotypes from removed orthopedic implants.
- To correlate P. acnes phylotypes with the presence or absence of orthopedic implant infection.
- To determine if specific P. acnes phylotypes are associated with infection versus colonization.
Main Methods:
- Prospective trial involving the analysis of removed orthopedic implants.
- Isolation and identification of Propionibacterium species from implant surfaces.
- Phylogenetic typing of Propionibacterium acnes isolates into types IA, IB, II, and III.
- Correlation of identified phylotypes with clinical data on infection status.
Main Results:
- Propionibacterium acnes was the predominant species isolated (61 out of 62 isolates).
- P. acnes type I (62%) was more common than type II (38%), irrespective of infection status.
- No significant association was found between P. acnes types I and II and orthopedic implant infection or colonization (P = 0.75).
- P. acnes type IB strains were isolated more frequently from infected prostheses compared to type IA.
Conclusions:
- Phylogenetic typing of P. acnes (types I and II) does not reliably differentiate between infection and colonization of orthopedic implants.
- While not definitive, a higher prevalence of P. acnes type IB in infected implants warrants further investigation.
- Further research is needed to understand the specific roles of P. acnes phylotypes in orthopedic implant infections.
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