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Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome

Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome
Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome
An increasing number of reports suggest that Propionibacterium acnes can cause serious invasive infections. Currently, only limited data exist regarding the spectrum of invasive P. acnes infections. We conducted a non-selective cohort study at a tertiary hospital in the UK over a 9-year-period (2003–2012) investigating clinical manifestations, risk factors, management, and outcome of invasive P. acnes infections. Forty-nine cases were identified; the majority were neurosurgical infections and orthopaedic infections (n?=?28 and n?=?15 respectively). Only 2 cases had no predisposing factors; all neurosurgical and 93.3 % of orthopaedic cases had a history of previous surgery and/or trauma. Foreign material was in situ at the infection site in 59.3 % and 80.0 % of neurosurgical and orthopaedic cases respectively. All neurosurgical and orthopaedic cases required one or more surgical interventions to treat P. acnes infection, with or without concomitant antibiotic therapy; the duration of antibiotic therapy was significantly longer in the group of orthopaedic cases (median 53 vs 19 days; p?=?0.0025). All tested P. acnes isolates were susceptible to penicillin, ampicillin and chloramphenicol; only 1 was clindamycin-resistant. Neurosurgical and orthopaedic infections account for the majority of invasive P. acnes infections. Most cases have predisposing factors, including previous surgery and/or trauma; spontaneous infections are rare. Foreign material is commonly present at the site of infection, indicating that the pathogenesis of invasive P. acnes infections likely involves biofilm formation. Since invasive P. acnes infections are associated with considerable morbidity, further studies are needed to establish effective prevention and optimal treatment strategies.
0934-9723
527-534
Tebruegge, M.
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Jones, C.
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De Graaf, H.
447e78ed-346f-45bb-9238-fce2118d5559
Sukhtankar, P.
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Allan, R.
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Howlin, R.
c2264245-b6cf-485d-b8bf-7a059e72bb79
Browning, D.
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Schuster, H.
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Pallett, A.
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Patel, S.
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Faust, S.N.
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Tebruegge, M.
2c3dff22-0b5f-48a7-bb36-ce323705f74a
Jones, C.
efc76da3-efd7-43ed-89c3-bf4c9a7951a7
De Graaf, H.
447e78ed-346f-45bb-9238-fce2118d5559
Sukhtankar, P.
b1774b6f-c957-4385-87aa-14ac647983b5
Allan, R.
390a7d0a-38e1-410a-8dfe-c8ef8408f5e1
Howlin, R.
c2264245-b6cf-485d-b8bf-7a059e72bb79
Browning, D.
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Schuster, H.
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Pallett, A.
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Patel, S.
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Faust, S.N.
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Tebruegge, M., Jones, C., De Graaf, H., Sukhtankar, P., Allan, R., Howlin, R., Browning, D., Schuster, H., Pallett, A., Patel, S. and Faust, S.N. (2015) Invasive Propionibacterium acnes infections in a non-selective patient cohort: clinical manifestations, management and outcome. European Journal of Clinical Microbiology & Infectious Diseases, 34 (3), 527-534. (doi:10.1007/s10096-014-2256-y). (PMID:25326276)

Record type: Article

Abstract

An increasing number of reports suggest that Propionibacterium acnes can cause serious invasive infections. Currently, only limited data exist regarding the spectrum of invasive P. acnes infections. We conducted a non-selective cohort study at a tertiary hospital in the UK over a 9-year-period (2003–2012) investigating clinical manifestations, risk factors, management, and outcome of invasive P. acnes infections. Forty-nine cases were identified; the majority were neurosurgical infections and orthopaedic infections (n?=?28 and n?=?15 respectively). Only 2 cases had no predisposing factors; all neurosurgical and 93.3 % of orthopaedic cases had a history of previous surgery and/or trauma. Foreign material was in situ at the infection site in 59.3 % and 80.0 % of neurosurgical and orthopaedic cases respectively. All neurosurgical and orthopaedic cases required one or more surgical interventions to treat P. acnes infection, with or without concomitant antibiotic therapy; the duration of antibiotic therapy was significantly longer in the group of orthopaedic cases (median 53 vs 19 days; p?=?0.0025). All tested P. acnes isolates were susceptible to penicillin, ampicillin and chloramphenicol; only 1 was clindamycin-resistant. Neurosurgical and orthopaedic infections account for the majority of invasive P. acnes infections. Most cases have predisposing factors, including previous surgery and/or trauma; spontaneous infections are rare. Foreign material is commonly present at the site of infection, indicating that the pathogenesis of invasive P. acnes infections likely involves biofilm formation. Since invasive P. acnes infections are associated with considerable morbidity, further studies are needed to establish effective prevention and optimal treatment strategies.

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Accepted/In Press date: 24 September 2014
e-pub ahead of print date: 18 October 2014
Published date: March 2015
Organisations: Faculty of Medicine

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Local EPrints ID: 396978
URI: http://eprints.soton.ac.uk/id/eprint/396978
ISSN: 0934-9723
PURE UUID: 89546821-db32-4fbd-96e6-2ecce1546d30
ORCID for S.N. Faust: ORCID iD orcid.org/0000-0003-3410-7642

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Date deposited: 17 Jun 2016 12:44
Last modified: 18 Feb 2021 17:07

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Contributors

Author: M. Tebruegge
Author: C. Jones
Author: H. De Graaf
Author: P. Sukhtankar
Author: R. Allan
Author: R. Howlin
Author: D. Browning
Author: H. Schuster
Author: A. Pallett
Author: S. Patel
Author: S.N. Faust ORCID iD

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