Origin of Propionibacterium in Surgical Wounds and Evidence-Based Approach for Culturing Propionibacterium from Surgical Sites
Propionibacterium is commonly recovered from deep cultures obtained at the time of revision shoulder arthroplasty - even if the shoulder shows none of the characteristic clinical evidence of infection. The purpose of this study was to explore the origin of Propionibacterium in surgical wounds and to seek an optimized strategy for culturing this organism at the time of revision surgery.
Part I: In 23 of 30 volunteers, cultures taken from unprepared epidermis over the deltopectoral incisional area grew Propionibacterium. Cultures from males were more positive than those from females (p<.002)
Part I: In 23 of 30 volunteers, cultures taken from unprepared epidermis over the deltopectoral incisional area grew Propionibacterium. Cultures from males were more positive than those from females (p<.002)
Part II: In 41 patients having revision shoulder arthroplasty, only 1 of the 20 females had any positive culture while 12 males had positive dermal cultures and 12 had positive deep cultures - these two positive findings were significantly associated (p .0001).
Part III: In the 74 shoulders with a Propionibacterium score>0.1, 372 cultures (average 5 per shoulder) were obtained of which 203 were positive. Cultures of component explants and soft tissues were positive in over half of the cases; fluid cultures were positive in only 40%. Anaerobic Brucella media were positive in 70%; aerobic and broth media were each positive in 52%. If only the Brucella media had been used, 30% of the 203 positive cultures would have been missed. The average time for the cultures to turn positive was 8.0 days +/- 4.7 days (range 1-25 days).
The chance of recovering Propionibacterium that are present in a surgical wound is optimized (95%) if (a) four different non-fluid specimens are obtained, (b) specimens are cultured on aerobic, anaerobic and broth media, and (c) the cultures are observed for a minimum of 17 days.
===
Consultation for those who live a distance away from Seattle.
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'