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%.
They pointed to the observation that three separate clusters of genes that drive production of extracellular polysacccharadies and adhesion proteins that form biofilms. Futhermore, P. Acnes isolates from invasive infections are able to form biofilms, whereas those from healthy skin are not as able. Thus biofilm formation production may be a virulence factor for prosthetic infections. As is well recognized, biofilms may contribute to the failure of antibiotics to resolve prosthetic infections.
In a prior publication, we have pointed out that special culture strategies may be necessary to recover Propionibacterium from surgical wounds.
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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