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Corvec S, Fayoux E, Tessier E, Guillouzouic A, Moraru C, Lecomte R, Bémer P, Ruffier d'Epenoux L. Cutibacterium namnetense osteosynthetic cervical spine infections: experience with two cases. Eur J Clin Microbiol Infect Dis 2024; 43:395-399. [PMID: 38093085 DOI: 10.1007/s10096-023-04731-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/28/2023] [Indexed: 01/28/2024]
Abstract
We report two uncommon cases of osteosynthetic cervical spine infection. Clinical patient features, microbiological strain characteristics, diagnostic methods, and treatment were analyzed. Both patients were male, and one had risk factors for surgical site infection. During surgery, perioperative samples were positive yielding an anaerobic microorganism identified as Cutibacterium namnetense by MALDI-TOF MS and confirmed by 16S rRNA/gyrB genes sequencing. All isolates were fully susceptible. C. namnetense osteosynthetic cervical spine infections are rare. Both cases were early surgical site infections. Bruker MALDI-TOF MS appears to be an excellent tool for rapid and accurate identification. Amoxicillin seems to be an option for the treatment.
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Affiliation(s)
- S Corvec
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie Et Des Contrôles Microbiologiques, CHU Nantes, Nantes Université, 9 Quai Moncousu, 44093, Cedex 01, Nantes, France.
- Nantes Study Group Members of CRIOGO (Centre de Référence Des Infections Ostéo-Articulaires du Grand Ouest), Nantes, France.
- Université de Nantes, CHU Nantes, INSERM, INCIT, U1302 F- 44000, Nantes, France.
| | - E Fayoux
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie Et Des Contrôles Microbiologiques, CHU Nantes, Nantes Université, 9 Quai Moncousu, 44093, Cedex 01, Nantes, France
| | - E Tessier
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie Et Des Contrôles Microbiologiques, CHU Nantes, Nantes Université, 9 Quai Moncousu, 44093, Cedex 01, Nantes, France
| | - A Guillouzouic
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie Et Des Contrôles Microbiologiques, CHU Nantes, Nantes Université, 9 Quai Moncousu, 44093, Cedex 01, Nantes, France
| | - C Moraru
- CHU Nantes, Service de Neuro-Chirurgie, Nantes, France
| | - R Lecomte
- CHU Nantes, Service Des Maladies Infectieuses, Nantes Université, Nantes, France
| | - P Bémer
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie Et Des Contrôles Microbiologiques, CHU Nantes, Nantes Université, 9 Quai Moncousu, 44093, Cedex 01, Nantes, France
- Nantes Study Group Members of CRIOGO (Centre de Référence Des Infections Ostéo-Articulaires du Grand Ouest), Nantes, France
| | - L Ruffier d'Epenoux
- Institut de Biologie des Hôpitaux de Nantes, Service de Bactériologie Et Des Contrôles Microbiologiques, CHU Nantes, Nantes Université, 9 Quai Moncousu, 44093, Cedex 01, Nantes, France
- Nantes Study Group Members of CRIOGO (Centre de Référence Des Infections Ostéo-Articulaires du Grand Ouest), Nantes, France
- Université de Nantes, CHU Nantes, INSERM, INCIT, U1302 F- 44000, Nantes, France
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Lacasse M, Derolez S, Bonnet E, Amelot A, Bouyer B, Carlier R, Coiffier G, Cottier JP, Dinh A, Maldonado I, Paycha F, Ziza JM, Bemer P, Bernard L. 2022 SPILF - Clinical Practice guidelines for the diagnosis and treatment of disco-vertebral infection in adults. Infect Dis Now 2023; 53:104647. [PMID: 36690329 DOI: 10.1016/j.idnow.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 12/12/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023]
Abstract
These guidelines are an update of those made in 2007 at the request of the French Society of Infectious Diseases (SPILF, Société de Pathologie Infectieuse de Langue Française). They are intended for use by all healthcare professionals caring for patients with disco-vertebral infection (DVI) on spine, whether native or instrumented. They include evidence and opinion-based recommendations for the diagnosis and management of patients with DVI. ESR, PCT and scintigraphy, antibiotic therapy without microorganism identification (except for emergency situations), therapy longer than 6 weeks if the DVI is not complicated, contraindication for spinal osteosynthesis in a septic context, and prolonged dorsal decubitus are no longer to be done in DVI management. MRI study must include exploration of the entire spine with at least 2 orthogonal planes for the affected level(s). Several disco-vertebral samples must be performed if blood cultures are negative. Short, adapted treatment and directly oral antibiotherapy or early switch from intravenous to oral antibiotherapy are recommended. Consultation of a spine specialist should be requested to evaluate spinal stability. Early lifting of patients is recommended.
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Affiliation(s)
- M Lacasse
- Medecine Interne et Maladies Infectieuses, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - S Derolez
- Rhumatologie, 125 rue de Stalingrad, CHU Avicenne, 93000 Bobigny, France
| | - E Bonnet
- Maladies Infectieuses, Pl. Dr Baylac, CHU Purpan, 31000 Toulouse, France.
| | - A Amelot
- Neurochirurgie, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - B Bouyer
- Chirurgie orthopédique et traumatologique, CHU de Bordeaux, Place Amélie Raba-léon, 33076 Bordeaux, France
| | - R Carlier
- Imagerie, Hôpital Raymond Poincaré, 104 Bd R Poincaré, 92380 Garches, France
| | - G Coiffier
- Rhumatologie, GH Rance-Emeraude, Hôpital de Dinan, 22100 Dinan, France
| | - J P Cottier
- Radiologie, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - A Dinh
- Maladies Infecteiuses, CHU Raymond Poicaré, 92380 Garches, France
| | - I Maldonado
- Radiologie, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
| | - F Paycha
- Médecine Nucléaire, Hôpital Lariboisière, 2 rue Ambroise Paré 75010 Paris, France
| | - J M Ziza
- Rhumatologie et Médecine Interne. GH Diaconesses Croix Saint Simon, 75020 Paris, France
| | - P Bemer
- Microbiologie, CHU de Nantes, 1 Place A. Ricordeau, Nantes 44000 Cedex 1, France
| | - L Bernard
- Medecine Interne et Maladies Infectieuses, 2 Bd Tonnelé, CHU Bretonneau, 37044 Tours Cedex 09, France
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Sagkrioti M, Glass S, Arealis G. Evaluation of the effectiveness of skin preparation methods for the reduction of Cutibacterium acnes (formerly Propionibacterium acnes) in shoulder surgery: a systematic review. Shoulder Elbow 2022; 14:583-597. [PMID: 36479010 PMCID: PMC9720868 DOI: 10.1177/17585732211032523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/15/2021] [Indexed: 12/22/2022]
Abstract
Background Cutibacterium acnes (C. acnes) is the most common pathogen responsible for post-operative shoulder infections. The purpose of this study was to evaluate the effectiveness of skin preparation methods against C. acnes in shoulder surgery. Methods A systematic review was conducted evaluating the effectiveness of skin preparation methods in the reduction of C. acnes in patients undergoing shoulder surgery. Outcomes were assessed based on the effectiveness of the method used; side effects and cost were also analysed. Results Of the 19 included studies, 9 evaluated pre-surgical home treatments: 8 assessed benzoyl peroxide (BPO) and 6 concluded it is effective in reducing C. acnes. Nine studies assessed surgical skin preparation and concluded that Chlorhexidine gluconate (CHG) was not effective; in contrast hydrogen peroxide reduced C. acnes. Finally, one study evaluated an aseptic protocol using CHG and concluded that it was not effective. Conclusions It was demonstrated that BPO as home treatment is effective in reducing C. acnes load on skin; it rarely causes side effects and is also cost-effective. This study highlights non-effectiveness of CHG. There was some evidence that the addition of hydrogen peroxide could have a positive effect in the reduction of C. acnes skin load; however, more studies are required.
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Affiliation(s)
- Maria Sagkrioti
- Department of Infection Prevention and Control, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - Stephen Glass
- Department of Microbiology, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
| | - Georgios Arealis
- Department of Trauma and Orthopaedics, East Kent Hospitals University NHS Foundation Trust, Canterbury, UK
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Götte L, Rübberdt A. [Salvage procedure for chronic periprosthetic infection : Use of a rifampicin-loaded polymethyl methacrylate spacer]. Unfallchirurg 2021; 125:497-500. [PMID: 34878580 DOI: 10.1007/s00113-021-01048-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/24/2022]
Abstract
Periprosthetic infections with problematic and multiresistant pathogens represent a great challenge for trauma surgeons, especially when repetitive surgical débridement combined with calculated i.v. antibiotic treatment does not lead to resolution of the infection. This can necessitate a deviation from state of the art treatment concepts, such as the additive implementation of a rifampicin-loaded polymethyl methacrylate (PMMA) spacers.
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Affiliation(s)
- Lea Götte
- Zentrum für Orthopädie und Unfallchirurgie, Unfallchirurgische Klinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld, Teutoburger Straße 50, 33604, Bielefeld, Deutschland.
| | - Alexander Rübberdt
- Zentrum für Orthopädie und Unfallchirurgie, Unfallchirurgische Klinik, Universitätsklinikum OWL der Universität Bielefeld, Campus Klinikum Bielefeld, Teutoburger Straße 50, 33604, Bielefeld, Deutschland
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Kusejko K, Auñón Á, Jost B, Natividad B, Strahm C, Thurnheer C, Pablo-Marcos D, Slama D, Scanferla G, Uckay I, Waldmann I, Esteban J, Lora-Tamayo J, Clauss M, Fernandez-Sampedro M, Wouthuyzen-Bakker M, Ferrari MC, Gassmann N, Sendi P, Jent P, Morand PC, Vijayvargiya P, Trebše R, Patel R, Kouyos RD, Corvec S, Kramer TS, Stadelmann VA, Achermann Y. The Impact of Surgical Strategy and Rifampin on Treatment Outcome in Cutibacterium Periprosthetic Joint Infections. Clin Infect Dis 2021; 72:e1064-e1073. [PMID: 33300545 DOI: 10.1093/cid/ciaa1839] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Cutibacterium species are common pathogens in periprosthetic joint infections (PJI). These infections are often treated with β-lactams or clindamycin as monotherapy, or in combination with rifampin. Clinical evidence supporting the value of adding rifampin for treatment of Cutibacterium PJI is lacking. METHODS In this multicenter retrospective study, we evaluated patients with Cutibacterium PJI and a minimal follow-up of 12 months. The primary endpoint was clinical success, defined by the absence of infection relapse or new infection. We used Fisher's exact tests and Cox proportional hazards models to analyze the effect of rifampin and other factors on clinical success after PJI. RESULTS We included 187 patients (72.2% male, median age 67 years) with a median follow-up of 36 months. The surgical intervention was a 2-stage exchange in 95 (50.8%), 1-stage exchange in 51 (27.3%), debridement and implant retention (DAIR) in 34 (18.2%), and explantation without reimplantation in 7 (3.7%) patients. Rifampin was included in the antibiotic regimen in 81 (43.3%) cases. Infection relapse occurred in 28 (15.0%), and new infection in 13 (7.0%) cases. In the time-to-event analysis, DAIR (adjusted hazard ratio [HR] = 2.15, P = .03) and antibiotic treatment over 6 weeks (adjusted HR = 0.29, P = .0002) significantly influenced treatment failure. We observed a tentative evidence for a beneficial effect of adding rifampin to the antibiotic treatment-though not statistically significant for treatment failure (adjusted HR = 0.5, P = .07) and not for relapses (adjusted HR = 0.5, P = .10). CONCLUSIONS We conclude that a rifampin combination is not markedly superior in Cutibacterium PJI, but a dedicated prospective multicenter study is needed.
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Affiliation(s)
- Katharina Kusejko
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Bernhard Jost
- Department of Orthopaedics and Traumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Benito Natividad
- Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Departament of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carol Strahm
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Christine Thurnheer
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | | | - Giulia Scanferla
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Ilker Uckay
- University Hospital Zurich, Orthopedic University Hospital Balgrist, Zurich, Switzerland
| | - Isabelle Waldmann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | - Martin Clauss
- Center for Musculoskeletal Infections, Department for Orthopedics and Trauma Surgery, University Hospital Basel, University of Basel, Basel, and Kantonsspital Baselland, Liestal, Switzerland
| | | | - Marjan Wouthuyzen-Bakker
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Matteo Carlo Ferrari
- Humanitas Clinical and Research Center -IRCCS and Humanitas University, Department of Biomedical Sciences, Milan, Italy
| | - Natalie Gassmann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Parham Sendi
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Jent
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | | | - Rihard Trebše
- Medical Faculty University of Ljubljana, Valdoltra Orthopedic Hospital, Ankaran, Slovenia
| | | | - Roger D Kouyos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Stéphane Corvec
- Service de Bactériologie- Hygiène hospitalière, CRCINA, Université de Nantes, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Tobias Siegfried Kramer
- Charité Universitätsmedizin Berlin, Berlin, Germany; Evangelisches Waldkrankenhaus Spandau, Berlin, Germany LADR Zentrallabor Dr. Kramer und Kollegen, Geesthacht, Germany
| | | | - Yvonne Achermann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Emerging medical treatments for hidradenitis suppurativa. J Am Acad Dermatol 2020; 83:554-562. [PMID: 32289386 DOI: 10.1016/j.jaad.2020.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 03/27/2020] [Accepted: 04/02/2020] [Indexed: 02/07/2023]
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting intertriginous skin areas, and it is characterized by recurrent painful episodes of inflammatory drainage. Although the pathophysiology of HS is not fully understood, recent research points to an imbalance of cytokines as a contributing factor to the associated symptoms of purulent drainage and sinus tract formation. HS lesions are often characterized by a superimposed pathogenic/commensal bacterial infection that can improve with targeted antibiotic therapy. New medical treatments have emerged in recent years, many of which specifically work against a variety of proinflammatory mediators associated with HS. These newer, specified treatment options, in conjunction with surgery and lasers, are thought to provide positive outcomes and an overall improvement in quality of life in patients with HS.
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Reitzel RA, Rosenblatt J, Gerges BZ, Jarjour A, Fernández-Cruz A, Raad II. The potential for developing new antimicrobial resistance from the use of medical devices containing chlorhexidine, minocycline, rifampicin and their combinations: a systematic review. JAC Antimicrob Resist 2020; 2:dlaa002. [PMID: 34222960 PMCID: PMC8210168 DOI: 10.1093/jacamr/dlaa002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/04/2019] [Accepted: 12/15/2019] [Indexed: 12/13/2022] Open
Abstract
Background Catheter infections remain one of the most persistent adverse events causing significant morbidity, economic impact and mortality. Several strategies have been proposed to reduce these infections including the use of catheters embedded with antibiotics and/or antiseptics. One reoccurring challenge is the fear that antimicrobial medical devices will induce resistance. The aim of this systematic review is to evaluate the evidence for induced antimicrobial resistance caused by exposure to antimicrobial medical devices. Methods Four electronic databases [MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus] were screened for studies published between 1983 and 2019 regarding assessment of microbial resistance with use of medical devices containing chlorhexidine, minocycline, rifampicin or combinations thereof. Development of new resistance, selection for tolerant organisms and 'no change in resistance' were assessed. Results Forty-four publications, grouped by study type and stratified by drug assessed, were included for analyses. The majority of studies found no change in resistance after exposure to antimicrobial medical devices (13 in vitro, 2 in vivo, 20 clinical). Development of new resistance was commonly reported with the use of rifampicin as a single agent and only reported in one study assessing the minocycline/rifampicin combination (M/R); however, the increase in MIC was well below clinical relevance. Conclusions Emergence of new resistance to combinations of M/R, minocycline/rifampicin/chlorhexidine (M/R/CH) and chlorhexidine/silver sulfadiazine (CHXSS) was rare. No clinical trials confirmed its occurrence and some refuted it. The risk of development of new resistance to these antimicrobial combinations appears more fear-based than substantiated by clinical and experimental evidence but warrants continued surveillance.
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Affiliation(s)
- Ruth A Reitzel
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Joel Rosenblatt
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Bahgat Z Gerges
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Andrew Jarjour
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ana Fernández-Cruz
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Issam I Raad
- Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Caposiena Caro R, Bianchi L. Clindamycin alone may be enough. Is it time to abandon rifampicin for hidradenitis suppurativa? Br J Dermatol 2019; 180:1262. [DOI: 10.1111/bjd.17597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R.D. Caposiena Caro
- Dermatology Department Department of Systems Medicine University of Rome Tor Vergata Rome Italy
| | - L. Bianchi
- Dermatology Department Department of Systems Medicine University of Rome Tor Vergata Rome Italy
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9
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Albrecht J, Barbaric J, Nast A. Clindamycin alone may be enough. Is it time to abandon rifampicin for hidradenitis suppurativa? Reply from the authors. Br J Dermatol 2019; 180:1262-1263. [DOI: 10.1111/bjd.17600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Albrecht
- Division of Dermatology Department of Medicine J.H. Stroger Hospital of Cook County Chicago IL U.S.A
- Department of Dermatology Rush Medical College Chicago IL U.S.A
| | - J. Barbaric
- Charité – Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Department of Dermatology Venerology und Allergy Division of Evidence‐Based Medicine (dEBM)Department of Dermatology Charité Berlin
| | - A. Nast
- Charité – Universitätsmedizin Berlin corporate member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Department of Dermatology Venerology und Allergy Division of Evidence‐Based Medicine (dEBM)Department of Dermatology Charité Berlin
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Torrens C, Marí R, Alier A, Puig L, Santana F, Corvec S. Cutibacterium acnes in primary reverse shoulder arthroplasty: from skin to deep layers. J Shoulder Elbow Surg 2019; 28:839-846. [PMID: 30685278 DOI: 10.1016/j.jse.2018.10.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/06/2018] [Accepted: 10/19/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND The aim of this study was to determine the presence of Cutibacterium acnes (formerly Propionibacterium acnes) on the skin and in deep tissue in a real clinical scenario of primary reverse shoulder arthroplasty. METHODS This prospective study included 90 primary reverse shoulder arthroplasties, and 12 cultures were obtained from each patient. Each sample was homogenized and used to inoculate PolyVitex (bioMérieux, Marcy-l'Etoile, France) agar and Schaedler (bioMérieux) agar plates. The same procedure was also followed with a thioglycolate broth. Culture was considered positive for C acnes when 2 or more colonies were observed. Total DNA from C acnes isolates was extracted using the InstaGene Matrix (Bio-Rad Laboratories, Hercules, CA, USA) method. The phylotype was determined, and single-locus sequence typing was done on all isolates. RESULTS We obtained 1080 tissue cultures from the 90 patients included, and 62 of those tissue cultures (5.7%) were positive for C acnes. There were 22 C acnes-positive tissue cultures before prosthesis implantation and 40 after implantation. C acnes was isolated in 17 patients (18.8%). We sent 38 positive samples for blinded phylotyping, single-locus sequence typing, and multi-locus sequence typing type determination. Many of the clusters isolated belonged to phylotype IB and clonal complex (CC) 36 or phylotype II and CC53. DISCUSSION In the real scenario of patients undergoing primary reverse shoulder arthroplasty using antibiotic prophylaxis and standard preoperative skin preparation with chlorhexidine, C acnes was isolated in the deep layers of 18.8% of the patients. The C acnes K1 and K2 subtypes (belonging to phylotype II and CC53), reported to be commonly involved in prosthetic joint infection, were usually isolated.
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Affiliation(s)
- Carlos Torrens
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.
| | - Raquel Marí
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Albert Alier
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Lluis Puig
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Fernando Santana
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
| | - Stephane Corvec
- Bacteriology and Infection Control Unit, Centre Hospitalier Universitaire Nantes, Nantes University Hospital, Nantes, France; Center for Research in Cancerology and Immunology, Univervité de Nantes, Unit 1232, Nantes, France
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11
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Assessment of the Potential for Inducing Resistance in Multidrug-Resistant Organisms from Exposure to Minocycline, Rifampin, and Chlorhexidine Used To Treat Intravascular Devices. Antimicrob Agents Chemother 2019; 63:AAC.00040-19. [PMID: 30833430 DOI: 10.1128/aac.00040-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/24/2019] [Indexed: 02/07/2023] Open
Abstract
To assess the potential for the induction of antimicrobial resistance following repeated subinhibitory exposures to the combination minocycline (MIN), rifampin (RIF), and chlorhexidine (CHX), a total of 29 clinical microbial pathogenic isolates were repeatedly exposed to subinhibitory concentrations of MIN, RIF, and CHX for 20 passages. MICs of the MIN, RIF, and CHX combination were assessed at each passage to evaluate the potential for resistance to have been induced. The combination of MIN, RIF, and CHX showed significant antimicrobial efficacy and synergy against organisms resistant to all 3 individual components (MIC of ≥16 μg/ml for MIN or MIC of ≥4 μg/ml for RIF or CHX). Among the organisms originally resistant to 2 or more individual components and the organisms originally susceptible to 2 or more individual components, there was no evidence that organisms became resistant following 20 repeated subinhibitory exposure cycles to the triple combination. The risk of resistance developing to the triple combination is extremely low because microbes are inhibited or killed before resistance can simultaneously emerge to all three agents. Surveillance studies monitoring the development of resistance should be conducted in a clinical setting.
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Abstract
Objectives The purpose of this study was to examine the bactericidal efficacy of hydrogen peroxide (H2O2) on Cutibacterium acnes (C. acnes). We hypothesize that H2O2 reduces the bacterial burden of C. acnes. Methods The effect of H2O2 was assessed by testing bactericidal effect, time course analysis, growth inhibition, and minimum bactericidal concentration. To assess the bactericidal effect, bacteria were treated for 30 minutes with 0%, 1%, 3%, 4%, 6%, 8%, or 10% H2O2 in saline or water and compared with 3% topical H2O2 solution. For time course analysis, bacteria were treated with water or saline (controls), 3% H2O2 in water, 3% H2O2 in saline, or 3% topical solution for 5, 10, 15, 20, and 30 minutes. Results were analyzed with a two-way analysis of variance (ANOVA) (p < 0.05). Results Minimum inhibitory concentration of H2O2 after 30 minutes is 1% for H2O2 prepared in saline and water. The 3% topical solution was as effective when compared with the 1% H2O2 prepared in saline or water. The controls of both saline and water showed no reduction of bacteria. After five minutes of exposure, all mixtures of H2O2 reduced the percentage of live bacteria, with the topical solution being most effective (p < 0.0001). Maximum growth inhibition was achieved with topical 3% H2O2. Conclusion The inexpensive and commercially available topical solution of 3% H2O2 demonstrated superior bactericidal effect as observed in the minimum bactericidal inhibitory concentration, time course, and colony-forming unit (CFU) inhibition assays. These results support the use of topical 3% H2O2 for five minutes before surgical skin preparation prior to shoulder surgery to achieve eradication of C. acnes for the skin.Cite this article: P. Hernandez, B. Sager, A. Fa, T. Liang, C. Lozano, M. Khazzam. Bactericidal efficacy of hydrogen peroxide on Cutibacterium acnes. Bone Joint Res 2019;8:3-10. DOI: 10.1302/2046-3758.81.BJR-2018-0145.R1.
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Affiliation(s)
- P Hernandez
- Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - B Sager
- Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - A Fa
- Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - T Liang
- Department of Orthopaedic Surgery; Shoulder Service, University of Texas Southwestern Medical Center, Texas, USA
| | - C Lozano
- Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - M Khazzam
- Department of Orthopaedic Surgery; Shoulder Service, University of Texas Southwestern Medical Center, Texas, USA
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13
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Boyle KK, Kuo FC, Horcajada JP, Hughes H, Cavagnaro L, Marculescu C, McLaren A, Nodzo SR, Riccio G, Sendi P, Silibovsky R, Stammers J, Tan TL, Wimmer M. General Assembly, Treatment, Antimicrobials: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S225-S237. [PMID: 30360976 DOI: 10.1016/j.arth.2018.09.074] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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14
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Skedros JG, Henrie MK, Finlinson ED, Trachtenberg JD. Polymicrobial anaerobic infection with a deep abscess in the supraspinous fossa following a subacromial corticosteroid injection. BMJ Case Rep 2018; 11:11/1/e226598. [PMID: 30567107 PMCID: PMC6301599 DOI: 10.1136/bcr-2018-226598] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In September 2015, a male aged 61 years with poorly controlled diabetes (his only medical problem) had left shoulder surgery that included an arthroscopic acromioplasty with debridement of suture material from a rotator cuff repair done 10 years prior. A subacromial corticosteroid injection was given 7 months later for pain and reduced motion. Three weeks later a fulminate infection was evident. Cultures grew Propionibacterium acnes. Treatment included two arthroscopic debridement surgeries and 8 weeks of intravenous antibiotics (primarily daptomycin). Eight weeks after the cessation of the antibiotics, purulence recurred and tissue cultures then grew Staphylococcus epidermidis. Several additional surgeries were needed to control the infection. We failed to recognise that an abscess that extended from the subacromial space across the entire supraspinous fossa. We report this case to alert clinicians that a seemingly innocuous subacromial corticosteroid injection can lead to an atypical infection and also extend into the supraspinous fossa.
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15
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Corvec S, Guillouzouic A, Aubin GG, Touchais S, Grossi O, Gouin F, Bémer P. Rifampin-Resistant Cutibacterium (formerly Propionibacterium) namnetense Superinfection after Staphylococcus aureus Bone Infection Treatment. J Bone Jt Infect 2018; 3:255-257. [PMID: 30533347 PMCID: PMC6284097 DOI: 10.7150/jbji.30029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 10/25/2018] [Indexed: 01/13/2023] Open
Abstract
After rifampin and levofloxacin treatment for a Staphylococcus aureus bone infection, a pyogenic granuloma due to a newly described Cutibacterium species, C. namnetense developed on the tibia former external fixator. This rifampin resistant bacterium, selected during treatment, harbored a mutation in the rpoB gene. This case illustrates the possible in vivo selection of resistant mutant most likely due to the bacterial burden and therefore the importance of adequate bone infection treatment.
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Affiliation(s)
- Stéphane Corvec
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Nantes, France.,CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France.,Nantes study group member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France
| | | | | | - Sophie Touchais
- Nantes study group member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France.,Clinique chirurgicale orthopédique et traumatique, CHU de Nantes, Nantes, France
| | - Olivier Grossi
- Nantes study group member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France.,Service de Maladies infectieuses, CHU de Nantes, Nantes, France - Département de Médecine Interne -Infectiologie, Nouvelles Cliniques Nantaises, Nantes, France
| | - François Gouin
- Nantes study group member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France.,Clinique chirurgicale orthopédique et traumatique, CHU de Nantes, Nantes, France
| | - Pascale Bémer
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Nantes, France.,Nantes study group member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France
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16
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Hischebeth GT, Randau TM, Ploeger MM, Friedrich MJ, Kaup E, Jacobs C, Molitor E, Hoerauf A, Gravius S, Wimmer MD. Staphylococcus aureus versus Staphylococcus epidermidis in periprosthetic joint infection-Outcome analysis of methicillin-resistant versus methicillin-susceptible strains. Diagn Microbiol Infect Dis 2018; 93:125-130. [PMID: 30266398 DOI: 10.1016/j.diagmicrobio.2018.08.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 08/16/2018] [Accepted: 08/26/2018] [Indexed: 01/25/2023]
Abstract
Periprosthetic joint infections (PJIs) are a major complication in total joint arthroplasty. Staphylococcus aureus and coagulase-negative staphylococci are known to cause the majority of all PJIs. This study aimed to analyze the eradication rates of S. aureus and S. epidermidis with methicillin susceptibility and methicillin resistance in a 2-stage therapy algorithm. Seventy-four patients with PJI caused by methicillin-resistant S. aureus (MRSA), methicillin-resistant coagulase-negative staphylococci (MRSE), methicillin-susceptible S. aureus (MSSA), and methicillin-susceptible coagulase-negative staphylococci (MSSE) were included, and the outcome was analyzed retrospectively. After a minimal follow-up of 2 years, n = 56 patients (75.7%) were definitively free of infection. The analysis revealed significant differences between the groups, with eradication rates as follows: MSSA (92.6%), MSSE (95.2%), MRSA (80%), and MRSE (54.2%). MRSE showed a significantly lower rate of patients graded as "definitively free of infection" as compared to patients with infections caused by MSSA, MSSE, and MRSA.
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Affiliation(s)
- G T Hischebeth
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany.
| | - T M Randau
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Germany
| | - M M Ploeger
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Germany
| | - M J Friedrich
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Germany
| | - E Kaup
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Germany
| | - C Jacobs
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Germany
| | - E Molitor
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - A Hoerauf
- Institute of Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
| | - S Gravius
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Germany
| | - M D Wimmer
- Department of Orthopedics and Trauma Surgery, University Hospital Bonn, Germany
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17
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Renz N, Mudrovcic S, Perka C, Trampuz A. Orthopedic implant-associated infections caused by Cutibacterium spp. - A remaining diagnostic challenge. PLoS One 2018; 13:e0202639. [PMID: 30125299 PMCID: PMC6101412 DOI: 10.1371/journal.pone.0202639] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/07/2018] [Indexed: 12/22/2022] Open
Abstract
Background The definition criteria and clinical characteristics of implant-associated infection (IAI) caused by Cutibacterium (formerly Propionibacterium) spp. are poorly known. We analyzed microbiologically proven Cutibacterium orthopedic IAI in a prospective cohort. Methods Patients with periprosthetic joint infections (PJI) and fixation device–associated infections (FDAI) caused by Cutibacterium spp. were prospectively included. IAI was defined by significant growth of Cutibacterium spp. and presence of at least one non-microbiological criterion for infection. The McNemar’s chi-squared or binomial test was used to compare the performance of diagnostic tests. Results Of 121 patients with Cutibacterium IAI, 62 patients (51%) had PJI and 59 (49%) had FDAI. 109 infections (90%) were caused by C. acnes and 12 (10%) by C. avidum. The median time from implantation until diagnosis of infection was 15.7 months (interquartile range, 5–46.5 months). Clinical local signs were present in 30 patients (28%) and radiological implant loosening in 64 patients (63%). Culture sensitivity of sonication fluid was 84%, of peri-implant tissue 84% and of synovial or peri-implant fluid 56% after 14 days of incubation. Conclusion Cutibacterium IAI was diagnosed late in the disease course and presented with subtle signs. Prolonged culture incubation and implant sonication improved the poor performance of conventional microbiological tests. Due to lack of reliable diagnostic tests, Cutibacterium remains difficult to detect making the diagnosis challenging.
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Affiliation(s)
- Nora Renz
- Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany
- * E-mail:
| | - Stasa Mudrovcic
- Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany
| | - Carsten Perka
- Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany
| | - Andrej Trampuz
- Charité –Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Berlin, Germany
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18
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Pécastaings S, Roques C, Nocera T, Peraud C, Mengeaud V, Khammari A, Dréno B. Characterisation ofCutibacterium acnesphylotypes in acne andin vivoexploratory evaluation of Myrtacine®. J Eur Acad Dermatol Venereol 2018; 32 Suppl 2:15-23. [DOI: 10.1111/jdv.15042] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/24/2018] [Indexed: 12/29/2022]
Affiliation(s)
- S. Pécastaings
- Laboratoire de Génie Chimique; UMR 5503; Université de Toulouse, Université Paul Sabatier; CNRS; INPT; Toulouse Cedex 9 France
| | - C. Roques
- Laboratoire de Génie Chimique; UMR 5503; Université de Toulouse, Université Paul Sabatier; CNRS; INPT; Toulouse Cedex 9 France
- Fonderephar; Faculty of Pharmacy; Toulouse Cedex 9 France
- CHU Toulouse; Hôpital Purpan, Service de Bactériologie-Hygiène; Toulouse France
| | - Th. Nocera
- Clinical Skin Research Center; Pierre Fabre Dermo-Cosmetique; Toulouse France
| | - C. Peraud
- Clinical Skin Research Center; Pierre Fabre Dermo-Cosmetique; Toulouse France
| | - V. Mengeaud
- Laboratoires Dermatologiques Ducray; Pierre Fabre Dermo-Cosmétique; Cauquillous Lavaur France
| | - A. Khammari
- Department of Dermatology; CHU Nantes; CIC 1413; CRCINA; University Nantes; Nantes France
| | - B. Dréno
- Department of Dermatology; CHU Nantes; CIC 1413; CRCINA; University Nantes; Nantes France
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19
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Skedros JG, Adondakis MG, Brown EM, Oliver MR. Propionibacterium acnes and Staphylococcus epidermidis olecranon bursitis/osteomyelitis: a case involving surgical and antibiotic treatment. BMJ Case Rep 2018; 2018:bcr-2017-223782. [PMID: 29440139 PMCID: PMC5836702 DOI: 10.1136/bcr-2017-223782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This report describes a 63-year-old generally healthy male with septic olecranon bursitis caused by Propionibacterium acnes The patient sustained a small laceration after striking the posterior aspect of his left elbow on a metal railing when he was at a public swimming pool. We concluded that P. acnes was not initially detected because cultures were only kept for 5 days. Consequently, initial antibiotic treatment failed. P. acnes and Staphylococcus epidermidis grew in a subsequent tissue culture. The infection did not respond to intravenous vancomycin although soft-tissue debridements were done. This likely reflected the presence of olecranon osteomyelitis (seen on MRI scans) in addition to inadequate treatment with this antibiotic in the setting of a polymicrobial infection. Eventually, the infection was eradicated with multiple soft-tissue debridements in addition to the continuation of vancomycin with daily intravenous piperacillin/tazobactam that was added for the final 4 weeks of antibiotic treatment.
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Affiliation(s)
| | | | | | - Marquam R Oliver
- Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA
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20
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Lee CY, Huang CH, Lu PL, Ko WC, Chen YH, Hsueh PR. Role of rifampin for the treatment of bacterial infections other than mycobacteriosis. J Infect 2017; 75:395-408. [PMID: 28870736 DOI: 10.1016/j.jinf.2017.08.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 06/06/2017] [Accepted: 08/25/2017] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Rifampin was initially approved for the treatment of tuberculosis. Because of its low toxicity, broad-spectrum activity, and good bioavailability, rifampin is now commonly administered as combination antimicrobial therapy for the treatment of various infections caused by organisms other than mycobacteria. This review summarizes the most recent clinical studies on the use of rifampin combinations for treating four common non-mycobacterial infections: acute bacterial meningitis, infective endocarditis and bacteraemia, pneumonia, and biofilm-related infections. METHODS We performed a literature search of clinical studies published in English from January 2005 to June 2016 using the PubMed database with the search terms "rifampin" with "meningitis" or "infective endocarditis and bacteraemia" or "pneumonia" or "prosthetic joint infections. RESULTS Current evidence to support a rifampin combination therapy as a treatment for non-mycobacterial infections was largely based on in vitro/in vivo studies and non-comparable retrospective case series. Additionally, controlled clinical trials that directly compared outcomes resulting from rifampin treatment versus treatment without rifampin were limited. CONCLUSIONS Rifampin combination therapy appears promising for the treatment of non-mycobacterial infections. However, further definitive clinical trials are necessary to validate its use because the risk of adverse drug-drug interactions and of the emergence of rifampin resistance during treatment may outweigh the potential benefits.
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Affiliation(s)
- Chun-Yuan Lee
- Kaohsiung Medical University, Kaohsiung Medical University Hospital, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung, Taiwan; Center for Infectious Disease and Cancer Research (CICAR), Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chung-Hao Huang
- Kaohsiung Medical University, Kaohsiung Medical University Hospital, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung, Taiwan; Sepsis Research Center, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Graduate Institute of Medicine, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Kaohsiung Medical University, Kaohsiung Medical University Hospital, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan; Centre of Infection Control, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan
| | - Yen-Hsu Chen
- Kaohsiung Medical University, Kaohsiung Medical University Hospital, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung, Taiwan; Sepsis Research Center, Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Graduate Institute of Medicine, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, Hsin Chu, Taiwan.
| | - Po-Ren Hsueh
- Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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21
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Takoudju EM, Guillouzouic A, Kambarev S, Pecorari F, Corvec S. In vitro emergence of fluoroquinolone resistance in Cutibacterium (formerly Propionibacterium) acnes and molecular characterization of mutations in the gyrA gene. Anaerobe 2017; 47:194-200. [PMID: 28602804 DOI: 10.1016/j.anaerobe.2017.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 06/02/2017] [Accepted: 06/07/2017] [Indexed: 12/11/2022]
Abstract
In vitro occurrence of levofloxacin (LVX) resistance in C. acnes and characterization of its molecular background were investigated. The mutation frequency was determined by inoculation of 108 cfu of C. acnes ATCC 11827 (LVX MIC = 0.25 mg/L) on LVX-containing agar plates. The progressive emergence of resistance was studied by a second exposure to increasing LVX concentrations. For mutants, the QRDR regions including the gyrA and parC genes were sequenced and compared to both C. acnes ATCC 11827 and C. acnes KPA171202 reference sequences (NC006085). The importance of the efflux pump system in resistance was investigated by using inhibitors on selected resistant mutants with no mutation in the QRDR. C. acnes growth was observed on LVX-containing plates with mutation frequencies of 3. 8 cfu × 10-8 (8 × MIC) and 1.6 cfu × 10-7 (4 × MIC). LVX resistance emerged progressively after one-step or two-step assays. In LVX-resistant isolates, the MIC ranged from 0.75 to >32 mg/L. Mutations were detected exclusively in the gyrA gene. Ten genotypes were identified: G99 C, G99 D, D100N, D100 H, D100 G, S101L, S101W, A102 P, D105 H and A105 G. Mutants S101L and S101W were always associated with a high level of resistance. Mutants with no mutation in the QRDR were more susceptible when incubated with an efflux pump inhibitor (phenyl-arginine β-naphthylamide) only, suggesting, for the first time, the expression of such a system in C. acnes LVX-resistant mutants.
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Affiliation(s)
- Eve-Marie Takoudju
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France
| | | | - Stanimir Kambarev
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Frédéric Pecorari
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie-Hygiène Hospitalière, CHU NANTES, Nantes, France; CRCINA, INSERM, Université d'Angers, Université de Nantes, Nantes, France; Nantes Study Group Member of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest), Nantes, France.
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22
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Draft Genome Sequence of Highly Rifampin-Resistant Propionibacterium namnetense NTS 31307302T Isolated from a Patient with a Bone Infection. GENOME ANNOUNCEMENTS 2016; 4:4/4/e00819-16. [PMID: 27516511 PMCID: PMC4982290 DOI: 10.1128/genomea.00819-16] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Propionibacterium namnetense was recently described as a potential bone pathogen, which is closely related to Propionibacterium acnes, a skin commensal microorganism. Here, we report the draft genome sequence of the highly rifampin-resistant strain NTS 31307302T isolated from a patient with a tibia infection.
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23
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Corvec S, Aubin GG, Bayston R, Ashraf W. Which is the best treatment for prosthetic joint infections due to Propionibacterium acnes: need for further biofilm in vitro and experimental foreign-body in vivo studies? Acta Orthop 2016; 87:318-9. [PMID: 27045190 PMCID: PMC4900078 DOI: 10.3109/17453674.2016.1162037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Stéphane Corvec
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, and EA3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de Médecine, Nantes, France
| | - Guillaume G Aubin
- Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, and EA3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de Médecine, Nantes, France
| | - Roger Bayston
- BRIG, Academic Orthopaedics, University Hospitals Queen’s Medical Centre, Nottingham, UK
| | - Waheed Ashraf
- BRIG, Academic Orthopaedics, University Hospitals Queen’s Medical Centre, Nottingham, UK
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24
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Aubin GG, Bémer P, Guillouzouic A, Launay E, Geffroy L, Touchais S, Corvec S. Failure of combination therapy for Staphylococcus aureus bone infection: a case of in vivo selection with resistance to rifampicin and fusidic acid. Infect Dis (Lond) 2016; 48:699-702. [PMID: 27194514 DOI: 10.1080/23744235.2016.1183815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Staphylococcus aureus is one of the main etiologies of bone and device-related infections. Treatment of these orthopedic infections combines mostly rifampicin with other antibiotics. The recurrence or failure rate after fusidic acid/rifampicin treatment remains low (<10%). We discuss here a case of antibiotic treatment failure for Staphylococcus aureus bone infection with in vivo selection of rifampicin and fusidic acid resistance. We also report a new mutation in fusA gene involved in fusidic acid resistance.
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Affiliation(s)
- Guillaume G Aubin
- a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France ;,b Faculté de Médecine, EA3826 Thérapeutiques Cliniques et Expérimentales des Infections , Université de Nantes , Nantes , France ;,c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France
| | - Pascale Bémer
- a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France ;,c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France
| | - Aurélie Guillouzouic
- a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France
| | - Elise Launay
- d Service de Pédiatrie , CHU de Nantes , Nantes , France
| | - Loïc Geffroy
- e Service de Chirurgie Pédiatrique , CHU de Nantes , Nantes , France
| | - Sophie Touchais
- c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France ;,f Service de Chirurgie Orthopédique Traumatologie , CHU de Nantes , Nantes , France
| | - Stéphane Corvec
- a Service de Bactériologie-Hygiène hospitalière, CHU de Nantes, Institut de Biologie , Nantes Cedex , France ;,b Faculté de Médecine, EA3826 Thérapeutiques Cliniques et Expérimentales des Infections , Université de Nantes , Nantes , France ;,c Nantes study group members of CRIOGO (Centre de Référence des Infections Ostéo-articulaires du Grand Ouest) , Nantes , France
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25
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Hsu JE, Bumgarner RE, Matsen FA. Propionibacterium in Shoulder Arthroplasty: What We Think We Know Today. J Bone Joint Surg Am 2016; 98:597-606. [PMID: 27053589 DOI: 10.2106/jbjs.15.00568] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Propionibacterium is a slow-growing gram-positive rod that is part of the normal skin microbiome but can be found on culture of specimens from a large number of patients having revision shoulder arthroplasty performed for pain, stiffness, and component loosening. ➤ Propionibacterium infections do not present with obvious signs of infection, such as swelling, erythema, drainage, or tenderness, but rather are of the so-called stealth type, presenting with unexplained pain, stiffness, or component loosening months to years after the index arthroplasty. ➤ Not all propionibacteria are the same: certain subtypes of Propionibacterium are enriched with virulence factors that may enhance deep infection. ➤ Because propionibacteria typically reside in the pilosebaceous glands of the oily skin of the chest and back, standard surgical skin preparation solutions and even perioperative intravenous antibiotics are often inadequate at sterilizing the incision site; therefore, other prophylactic measures such as meticulous implant handling to avoid contact with dermal structures need to be considered. ➤ Recovery of Propionibacterium from the surgical wounds requires that multiple specimens for culture be taken from different areas of the shoulder to reduce sampling error, and cultures should be held for two weeks on multiple culture media. ➤ Future research efforts can be focused on reducing the risk of implant infection and point-of-care methods for identifying Propionibacterium infections.
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Affiliation(s)
- Jason E Hsu
- Departments of Orthopaedics and Sports Medicine (J.E.H and F.A.M.) and Microbiology (R.E.B.), University of Washington, Seattle, Washington
| | - Roger E Bumgarner
- Departments of Orthopaedics and Sports Medicine (J.E.H and F.A.M.) and Microbiology (R.E.B.), University of Washington, Seattle, Washington
| | - Frederick A Matsen
- Departments of Orthopaedics and Sports Medicine (J.E.H and F.A.M.) and Microbiology (R.E.B.), University of Washington, Seattle, Washington
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Feuillolay C, Pecastaings S, Le Gac C, Fiorini-Puybaret C, Luc J, Joulia P, Roques C. A Myrtus communis extract enriched in myrtucummulones and ursolic acid reduces resistance of Propionibacterium acnes biofilms to antibiotics used in acne vulgaris. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2016; 23:307-15. [PMID: 26969384 DOI: 10.1016/j.phymed.2015.11.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/11/2015] [Accepted: 11/22/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Recent works present evidence of Propionibacterium acnes growing as a biofilm in cutaneous follicles. This formation of clusters is now considered as an explanation for the in vivo resistance of P. acnes to the main antimicrobials prescribed in acne vulgaris. PURPOSE Our objective was to explore this hypothesis and propose a new therapeutic approach focusing on anti-biofilm activity of Myrtacine(®) New Generation (Mediterranean Myrtle extract-Botanical Expertise P. Fabre) alone or combined with antibiotics. METHODS/RESULTS Using in vitro models able to promote the growth of adhered bacteria, the loss of sensitivity of P. acnes biofilms (48 h) towards erythromycin and clindamycin was checked considering either sensitive or resistant strains. In the same time, the activity of Myrtacine(®) New Generation against biofilm formation and mature biofilm (48 h) was evaluated. Using a dynamic model of biofilm formation, we noted an inhibition of biofilm formation (addition of Myrtacine(®) New Generation at T 0) and a significant effect on mature biofilm (48 h) for 5 min of contact. This effect was also checked using the static model of biofilm formation for Myrtacine(®) New Generation concentrations ranging from 0.03% to 0.0001%. A significant, dose-dependent anti-biofilm effect was observed and notable even at a concentration lower than the active concentration on planktonic cells, i.e. 0.001%. Finally, the interest of the combination of Myrtacine(®) New Generation with antibiotics was explored. An enhanced efficacy was noted when erythromycin (1000 mg/l) or clindamycin (500 mg/l) was added to 0.001% Myrtacine(®), leading to significant differences in comparison to each compound used alone. CONCLUSION The efficiency of Myrtacine(®) New Generation on P. acnes biofilm alone or combined with antibiotics was demonstrated and can lead to consider it as a potent adjunctive product efficient during the antibiotic course for acne vulgaris treatment.
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Affiliation(s)
- Catherine Feuillolay
- Fonderephar, Faculty of Pharmacy, 35 chemin des Maraîchers, 31062 Toulouse cedex 9, France
| | - Sophie Pecastaings
- Fonderephar, Faculty of Pharmacy, 35 chemin des Maraîchers, 31062 Toulouse cedex 9, France; University Paul Sabatier, Laboratoire de Génie Chimique, UMR 5503, Faculty of Pharmacy, 35 chemin des Maraîchers, 31062 Toulouse cedex 9, France
| | - Céline Le Gac
- Fonderephar, Faculty of Pharmacy, 35 chemin des Maraîchers, 31062 Toulouse cedex 9, France
| | - Christel Fiorini-Puybaret
- Laboratory for vegetable products, Pierre Fabre Research Institute, Pierre Fabre R&D Center, 3 avenue Hubert Curien, 31100 Toulouse, France
| | - Joëlle Luc
- Microbiology Lab, Pierre Fabre DermoCosmetics R&D, 17 allée Camille Soula, 31320 Vigoulet-Auzil, France
| | - Philippe Joulia
- Laboratory for vegetable products, Pierre Fabre Research Institute, Pierre Fabre R&D Center, 3 avenue Hubert Curien, 31100 Toulouse, France
| | - Christine Roques
- Fonderephar, Faculty of Pharmacy, 35 chemin des Maraîchers, 31062 Toulouse cedex 9, France; University Paul Sabatier, Laboratoire de Génie Chimique, UMR 5503, Faculty of Pharmacy, 35 chemin des Maraîchers, 31062 Toulouse cedex 9, France.
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Aubin GG, Boutoille D, Bourcier R, Caillon J, Lepelletier D, Bémer P, Corvec S. Unusual Case of Spondylodiscitis due to Listeria monocytogenes. J Bone Jt Infect 2016; 1:7-9. [PMID: 28529845 PMCID: PMC5423564 DOI: 10.7150/jbji.13863] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Guillaume Ghislain Aubin
- Bacteriology and Hygiene Unit, Nantes University Hospital, France.,EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections - Nantes Medicine School, France
| | - David Boutoille
- EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections - Nantes Medicine School, France.,Infectious and Tropical Diseases Unit, Nantes University Hospital, France
| | - Romain Bourcier
- Interventional and Diagnostic Neuroradiology, Nantes University Hospital, France
| | - Jocelyne Caillon
- Bacteriology and Hygiene Unit, Nantes University Hospital, France.,EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections - Nantes Medicine School, France
| | - Didier Lepelletier
- Bacteriology and Hygiene Unit, Nantes University Hospital, France.,EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections - Nantes Medicine School, France
| | - Pascale Bémer
- Bacteriology and Hygiene Unit, Nantes University Hospital, France.,EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections - Nantes Medicine School, France
| | - Stéphane Corvec
- Bacteriology and Hygiene Unit, Nantes University Hospital, France.,EA3826, Laboratory of Clinical and Experimental Therapeutics of Infections - Nantes Medicine School, France
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