Cutibacterium avidum: A Potent and Underestimated Pathogen in Prosthetic Hip Joint Infections

Johanna Karlsson1,2, Nina Kamenska3, Erika Matuschek4

  • 1NU Hospital Group, Department of Infectious Diseases, 461 73 Trollhättan, Sweden.

Microorganisms
|March 28, 2024
PubMed

Insights

Cutibacterium avidum is an emerging cause of prosthetic joint infections (PJIs), challenging previous assumptions. This study identified four hip PJI cases, suggesting this pathogen may be underestimated and more virulent than previously thought.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Orthopedic Surgery

Background:

  • Cutibacterium avidum is a recently identified cause of prosthetic joint infections (PJIs).
  • Established causes like Cutibacterium acnes are well-documented, particularly in shoulder arthroplasties.
  • Previous reports linked C. avidum PJIs to obesity and specific surgical approaches.

Purpose of the Study:

  • To report four cases of hip PJIs caused by C. avidum.
  • To investigate the genetic relatedness and antibiotic susceptibility of C. avidum strains from PJI cases.
  • To assess the clinical presentation and risk factors associated with C. avidum PJI.

Main Methods:

  • Retrospective case series of four patients with hip PJIs caused by C. avidum over 30 months.
  • Whole-genome sequencing to analyze strain relatedness.
  • Antibiotic susceptibility testing to determine resistance profiles.

Main Results:

  • Four distinct C. avidum strains were identified, ruling out a common outbreak source.
  • All isolates were fully susceptible to tested antibiotics and lacked known resistance genes.
  • Patients exhibited clear signs of infection during surgery, indicating C. avidum's virulence.
  • Identified risk factors (obesity, direct anterior incision) did not apply to these cases.

Conclusions:

  • The occurrence of four cases suggests C. avidum may be an emerging or underestimated cause of PJIs.
  • C. avidum demonstrates virulence in causing hip PJIs.
  • The typical risk factors for C. avidum PJI may not be universally applicable.

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