Cutibacterium acnes in Shoulder Surgery: Is It a Significant Risk Factor for Postoperative Infection?

Area of Science:

• Microbiology
• Orthopedic Surgery
• Infectious Diseases

Background:

• Cutibacterium acnes (C. acnes) is a common skin bacterium with a propensity for causing orthopedic infections, particularly in the shoulder.
• The indolent nature of C. acnes complicates diagnosis via traditional clinical, laboratory, and culture-based methods.
• Uncertainty regarding C. acnes's pathogenic potential contributes to a lack of consensus on optimal treatment strategies.

Purpose of the Study:

• To comprehensively review the diagnostic challenges associated with C. acnes infections.
• To evaluate current and emerging treatment modalities for C. acnes infections.
• To determine the significance of C. acnes as a risk factor for shoulder joint infections.

Main Methods:

• Literature review of studies on C. acnes diagnosis and treatment in orthopedic infections.
• Analysis of clinical case reports and microbiological data related to C. acnes shoulder infections.
• Synthesis of evidence regarding the etiological role and risk factors of C. acnes in shoulder joint infections.

Main Results:

• Diagnostic difficulties arise from C. acnes's slow growth and commensal status.
• Treatment strategies vary due to debated pathogenicity, with ongoing research into novel approaches.
• Evidence suggests C. acnes is a significant factor in certain shoulder joint infections, necessitating specific diagnostic and therapeutic considerations.

Conclusions:

• Accurate diagnosis of C. acnes infections remains a challenge, requiring advanced methods beyond standard cultures.
• Consensus on treatment is evolving, highlighting the need for tailored approaches based on infection severity and patient factors.
• C. acnes should be considered a potential risk factor for shoulder joint infections, influencing clinical suspicion and management decisions.