Related Experiment Video
Updated: Mar 23, 2026
Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Propionibacterium prosthetic joint infection: experience from a retrospective database analysis
Anna Rienmüller1,2, Olivier Borens3
1Orthopedic Septic Surgical Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne, Switzerland. anna.rienmueller@meduniwien.ac.at.
Background:
With improved diagnostic methods and longer prosthesis indwelling time, the frequency of diagnosed Propionibacterium prosthetic joint infections (PJI) is increasing. Data on clinical, microbiological, radiological and surgical treatment are limited, and importance of this organism in PJI is probably underestimated.
Materials And Methods:
We retrospectively analyzed patients with PJI caused by Propionibacterium spp. diagnosed at our institution between 2000 and 2012. Patient data were retrieved through chart review, and the outcome was evaluated at patient follow-up visits.
Results:
Of 15 included patients (median age 65 years, range 44-87), 8 hip, 4 shoulder, 2 knee and 1 ankle PJI were recorded. The median time from implantation to diagnosis of PJI was 44.2 months (range 2-180 months). Most PJI (8 patients, 53 %) were diagnosed late (>24 months after arthroplasty). Persistent pain was present in 13, local joint symptoms in 8, fever in 4 and sinus tract in 3 patients. Radiological signs of loosening were present in 11 patients (73 %). Organisms were detected in intraoperative biopsy (n = 5), sonication (n = 4) or preoperative joint puncture (n = 4). In three cases coinfection with a coagulase-negative staphylococcus was diagnosed. Revision surgery was performed in all cases. After a mean follow-up of 16 months after revision surgery (range 4-37 months), 14 patients (93 %) showed no signs or symptoms of infection and had a functional prosthesis; one patient experienced a new infection with another organism (Staphylococcus epidermidis).
Conclusion:
Patients with persistent postoperative pain and/or loosening of implants should be screened for PJI with low-virulent organisms such as Propionibacterium, including.
Insights
Propionibacterium prosthetic joint infections (PJI) are increasingly diagnosed, often presenting late with persistent pain. Prompt screening for these low-virulent organisms is crucial for successful treatment and prosthesis survival.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Microbiology
Background:
- Propionibacterium prosthetic joint infections (PJI) are increasingly recognized due to improved diagnostics and longer prosthesis use.
- Limited data exists on the clinical, microbiological, and treatment aspects of Propionibacterium PJI, potentially leading to underestimation of its significance.
- This study addresses the need for better understanding of Propionibacterium PJI.
Purpose of the Study:
- To retrospectively analyze clinical, microbiological, and treatment outcomes of Propionibacterium spp. prosthetic joint infections.
- To evaluate the diagnostic challenges and treatment efficacy for this specific type of PJI.
- To highlight the importance of considering Propionibacterium in PJI diagnosis.
Main Methods:
- Retrospective analysis of patients diagnosed with Propionibacterium PJI between 2000 and 2012.
- Data collection through chart review and patient follow-up visits.
- Evaluation of clinical presentation, microbiological detection methods, and surgical outcomes.
Main Results:
- Fifteen patients with PJI caused by Propionibacterium spp. were included, with a median diagnosis time of 44.2 months post-implantation, often presenting late (>24 months).
- Common symptoms included persistent pain (93%), joint symptoms (53%), and radiological loosening (73%). Organisms were detected via biopsy, sonication, or puncture.
- All patients underwent revision surgery, with a high success rate (93%) achieving infection-free, functional prostheses at a mean follow-up of 16 months.
Conclusions:
- Patients with persistent postoperative pain or implant loosening should be screened for PJI caused by low-virulent organisms like Propionibacterium.
- Early and accurate diagnosis of Propionibacterium PJI is essential for effective management.
- This study underscores the clinical relevance of Propionibacterium in prosthetic joint infections.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:27Acute Pyelonephritis I: Introduction