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[Propionibacterium acnes infection in patients with CSF shunts]
A Bordes1, R Elcuaz, F J Noguera
1Servicies de Microbiología, Hospital Nuestra Seńora del Pino, Las Palmas de Gran Canaria.
Background And Methods:
Propionibacterium acnes is a common inhabitant of human skin rarely associated with clinical disease. However it has been recognized as a cause of shunt and postneurosurgical infections. From January 1992 to June 1995, 5,947 cerebrospinal fluid (CSF) samples were cultured in our laboratory. We carried out a clinical-epidemiological study in patients where P. acnes was isolated from CSF.
Results:
P, acnes was isolated from 11 CSF samples which corresponded to 7 episodes of shunt infection in 6 patients. Five were men; the mean age was 28.5 years. The mean time of onset of infection after the last shunt manipulation was 104 weeks. All of them presented symptomatology associated with infection. All episodes but one, where P. acnes was considered to be a contaminant, were treated with systemic and intraventricular antibiotic therapy and complete shunt removal. Four patients made an uneventful recovery and two patients died due to causes not directly related with the infection.
Conclusions:
P. acnes is frequently isolated in patients with shunt infections. Its isolation must be seriously considered not viewed as a contaminant without an exhaustive investigation.
Insights
Propionibacterium acnes (P. acnes) frequently causes shunt infections. This study highlights the importance of considering P. acnes a pathogen in cerebrospinal fluid infections, not a contaminant.
Area of Science:
- Neuroscience
- Infectious Disease
- Microbiology
Context:
- Propionibacterium acnes is a common skin bacterium.
- It is increasingly recognized as a cause of shunt and postneurosurgical infections.
- This study investigated P. acnes in cerebrospinal fluid (CSF) samples.
Purpose:
- To conduct a clinical-epidemiological study of patients with P. acnes isolated from CSF.
- To assess the role of P. acnes in shunt infections.
- To determine appropriate diagnostic and treatment considerations.
Summary:
- P. acnes was isolated from 11 CSF samples, corresponding to 7 shunt infection episodes in 6 patients.
- Infections occurred a mean of 104 weeks post-shunt manipulation.
- Treatment involved antibiotics and shunt removal, with most patients recovering.
Impact:
- P. acnes isolation from CSF warrants serious consideration as a cause of infection.
- Avoid viewing P. acnes as a contaminant without thorough investigation.
- Findings emphasize the need for vigilance in diagnosing P. acnes-related shunt infections.