The recent description of the genus Cutibacterium has altered the taxonomy of Propionibacterium species. These organisms still belong to the genera of the skin coryneform group, and the most-studied species remains Cutibacterium acnes. Cutibacterium avidum is also a known skin commensal. This underrecognized microorganism can, however, act as a pathogen after bacterial seeding and can be considered opportunistic, causing either superficial or deep/invasive infections. The ecological niche of C. avidum is clearly different from that of other members of the genus: it is found in the axillary region or at wet sites rather than in dry, exposed areas, and the number of microorganisms increases during puberty. C. avidum causes diverse diseases mediated by multiple virulence factors. The recent genome approach has revealed specific genomic regions within this species that are involved in adherence and biofilm formation as well as fitness, survival, and defense functions. C. avidum remains highly sensitive to a broad spectrum of antibiotics, such as β-lactams, fluoroquinolones, macrolides, and rifampin, although erythromycin and clindamycin resistance has been described.
Comment: We do see cases of C. avidum of the shoulder Here's one that presented to us 4 years after his index arthroplasty. At the time of revision, multiple deep cultures were positive for C avidum.
Here is a figure from the article. We have isolated all of these organisms from infected shoulder arthroplasties except C. namnetense, which has been reported in bone infections (see this link).
Here's another related article (using Cutibacterium's previous name)
Propionibacterium avidum – a virulent pathogen causing hip periprosthetic joint infection
These authors report four hip prosthetic joint infections caused by P. avidum in one orthopedic center in 2015. They also characterized the hemolytic and biofilm-producing capacity of the four clinical P. avidum strains and investigated their phylogenetic relationships by whole genome sequencing. On searching their records from 1997 to 2015 they retrospectively identified 13 P. avidum PJIs, with the majority being hip-related infections (n=11).
===
We have a new set of shoulder youtubes about the shoulder, check them out at this link.
These authors report four hip prosthetic joint infections caused by P. avidum in one orthopedic center in 2015. They also characterized the hemolytic and biofilm-producing capacity of the four clinical P. avidum strains and investigated their phylogenetic relationships by whole genome sequencing. On searching their records from 1997 to 2015 they retrospectively identified 13 P. avidum PJIs, with the majority being hip-related infections (n=11).
Preoperative synovial fluid cultures were P. avidum positive in 63.6% of cases. Six out of 12 patients (50%) with available case histories were treated with an exchange of the prosthesis. In all but one of the six patients treated with debridement-retention of the prosthesis, treatment failed thus requiring a two-stage revision.
The isolated P. avidum strains showed a more pronounced hemolytic activity, but a similar biofilm-forming ability when compared to P. acnes.
Whole genome sequencing identified two phylogenetic clusters highly related to P. avidum PJI strains isolated in Sweden.
As we become more accurate and precise in our characterization of Cutibacterium recovered from prosthetic joint infections, it is important to recognize that P. Acnes is not the only species of clinical importance as is pointed out in this article and in these links: Propionibacterium – What we think we know today and Genome Sequence of a Novel Species, Propionibacterium humerusii. As is true for other bacterial species, it is reasonable to expect that these other species (C. avidum, C. granulosum, C. humerusii, and perhaps others) may have different clinical features and different antibiotic sensitivities from C. acnes. We need to ask our laboratories to put forth the additional effort to speciate Cutibacterium rather than reporting them all as "C. acnes".
===
We have a new set of shoulder youtubes about the shoulder, check them out at this link.
Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link
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 arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'
