Propionibacterium acnes infection after shoulder surgery

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Microbiology

Background:

• Propionibacterium acnes (P. acnes) is a significant cause of post-shoulder surgery infections, potentially occurring up to two years after the procedure.
• P. acnes infections account for a substantial percentage (up to 56%) of shoulder infections associated with orthopedic implants.
• Male patients undergoing shoulder surgery, especially those involving prostheses or post-traumatic procedures, are at higher risk.

Purpose of the Study:

• To review the current understanding of Propionibacterium acnes infections following shoulder surgery.
• To highlight the importance of recognizing risk factors, signs, and symptoms of P. acnes infection.
• To summarize effective prevention and management strategies for P. acnes in shoulder surgery.

Main Methods:

• Comprehensive literature search of PubMed, Web of Science, and NICE Evidence Healthcare Databases.
• Inclusion of data from AMED, BNI, CINAHL, Embase, HMIC, Medline, and PsycINFO.
• Search terms included "P. acnes," "infection," "shoulder," and "surgery."

Main Results:

• P. acnes infections can be challenging to diagnose clinically due to subtle symptoms and normal inflammatory markers.
• Delayed diagnosis can lead to significant morbidity and potential prosthesis failure.
• P. acnes is a low-virulence organism, making laboratory diagnosis difficult and requiring specialized, prolonged cultures.

Conclusions:

• Awareness of P. acnes infection risk factors and clinical signs is essential for prompt diagnosis in shoulder surgery patients.
• Early diagnosis and appropriate treatment of P. acnes infections can significantly improve patient outcomes and prevent complications.
• Effective prevention and management strategies are critical for addressing P. acnes as a cause of shoulder surgery infections.