Monday, November 12, 2012

Propionibacterium acnes: infection beyond the skin.

Propionibacterium acnes: infection beyond the skin. is an interesting review by two Australian authors. It provides some information that was new to us about the bug that is causing growing concern in orthopaedics.

While it is widely recognized that propionibacter are commonly part of the skin microbiome (see also here) this article points out that these bacteria may also reside in the oral cavity, large intestine, and external auditory meatus. 

These organisms have been found to cause device-related infection of orthopaedic implants, heart valves and shunts. 

Rather than being only one strain, at least three distinct phenotypes with subclusters of strains have been identified using genome sequencing. These different strains may have different virulence and fitness. We reported the genome sequece of yet another species recovered from failed shoulder arthroplasties, which we named Propionibacterium humerusii

The authors of this article found a reported incidence of P. Acnes prosthetic joint infections ranging from 10 to over 60%. 

In addition to its seclusion in biofilms, antibiotic resistance is a growing issue in the treatment of Propionibacterium infections.  Recognizing that some strains of Propionibacterium are more virulent than others may enable selective treatment that preserves the normal skin flora.

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