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Etlin S, Rose J, Bielski L, Walter C, Kleinman AS, Mason CE. The human microbiome in space: parallels between Earth-based dysbiosis, implications for long-duration spaceflight, and possible mitigation strategies. Clin Microbiol Rev 2024; 37:e0016322. [PMID: 39136453 DOI: 10.1128/cmr.00163-22] [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] [Indexed: 09/13/2024] Open
Abstract
SUMMARYThe human microbiota encompasses the diverse communities of microorganisms that reside in, on, and around various parts of the human body, such as the skin, nasal passages, and gastrointestinal tract. Although research is ongoing, it is well established that the microbiota exert a substantial influence on the body through the production and modification of metabolites and small molecules. Disruptions in the composition of the microbiota-dysbiosis-have also been linked to various negative health outcomes. As humans embark upon longer-duration space missions, it is important to understand how the conditions of space travel impact the microbiota and, consequently, astronaut health. This article will first characterize the main taxa of the human gut microbiota and their associated metabolites, before discussing potential dysbiosis and negative health consequences. It will also detail the microbial changes observed in astronauts during spaceflight, focusing on gut microbiota composition and pathogenic virulence and survival. Analysis will then turn to how astronaut health may be protected from adverse microbial changes via diet, exercise, and antibiotics before concluding with a discussion of the microbiota of spacecraft and microbial culturing methods in space. The implications of this review are critical, particularly with NASA's ongoing implementation of the Moon to Mars Architecture, which will include weeks or months of living in space and new habitats.
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Affiliation(s)
- Sofia Etlin
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, USA
- Department of Biology, Cornell University, Ithaca, New York, USA
- BioAstra Inc., New York, New York, USA
| | - Julianna Rose
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, USA
- Department of Biology, Cornell University, Ithaca, New York, USA
- BioAstra Inc., New York, New York, USA
| | - Luca Bielski
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, USA
- Department of Biology, Cornell University, Ithaca, New York, USA
| | - Claire Walter
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, USA
- Department of Biology, Cornell University, Ithaca, New York, USA
- BioAstra Inc., New York, New York, USA
| | - Ashley S Kleinman
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, New York, USA
| | - Christopher E Mason
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, USA
- BioAstra Inc., New York, New York, USA
- The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medicine, New York, New York, USA
- The Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
- Tri-Institutional Biology and Medicine program, Weill Cornell Medicine, New York, New York, USA
- WorldQuant Initiative for Quantitative Prediction, Weill Cornell Medicine, New York, New York, USA
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Chudzik A, Bromke MA, Gamian A, Paściak M. Comprehensive lipidomic analysis of the genus Cutibacterium. mSphere 2024; 9:e0005424. [PMID: 38712970 PMCID: PMC11237483 DOI: 10.1128/msphere.00054-24] [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: 01/25/2024] [Accepted: 04/12/2024] [Indexed: 05/08/2024] Open
Abstract
Cutibacterium are part of the human skin microbiota and are opportunistic microorganisms that become pathogenic in immunodeficient states. These lipophilic bacteria willingly inhabit areas of the skin where sebaceous glands are abundant; hence, there is a need to thoroughly understand their metabolism. Lipids are no longer considered only structural elements but also serve as signaling molecules and may have antigenic properties. Lipidomics remains a major research challenge, mainly due to the diverse physicochemical properties of lipids. Therefore, this study aimed to perform a large comparative lipidomic analysis of eight representatives of the Cutibacterium genus, including four phylotypes of C. acnes and two strains of C. granulosum, C. avidum, and C. namnetense. Lipidomic analysis was performed by liquid chromatography‒mass spectrometry (LC-MS) in both positive and negative ion modes, allowing the detection of the widest range of metabolites. Fatty acid analysis by gas chromatography‒mass spectrometry (GC-MS) corroborated the lipidomic data. As a result, 128 lipids were identified, among which it was possible to select marker compounds, some of which were characteristic even of individual C. acnes phylotypes. These include phosphatidylcholine PC 30:0, sphingomyelins (SM 33:1, SM 35:1), and phosphatidylglycerol with an alkyl ether substituent PG O-32:0. Moreover, cardiolipins and fatty acid amides were identified in Cutibacterium spp. for the first time. This comparative characterization of the cutibacterial lipidome with the search for specific molecular markers reveals its diagnostic potential for clinical microbiology. IMPORTANCE Cutibacterium (previously Propionibacterium) represents an important part of the human skin microbiota, and its role in clinical microbiology is growing due to opportunistic infections. Lipidomics, apart from protein profiling, has the potential to prove to be a useful tool for defining the cellular fingerprint, allowing for precise differentiation of microorganisms. In this work, we presented a comparative analysis of lipids found in eight strains of the genus Cutibacterium, including a few C. acnes phylotypes. Our results are one of the first large-scale comprehensive studies regarding the bacterial lipidome, which also enabled the selection of C. acnes phylotype-specific lipid markers. The increased role of lipids not only as structural components but also as diagnostic markers or potential antigens has led to new lipid markers that can be used as diagnostic tools for clinical microbiology. We believe that the findings in our paper will appeal to a wide range of researchers.
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Affiliation(s)
- Anna Chudzik
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Mariusz A Bromke
- Department of Biochemistry and Immunochemistry, Wroclaw Medical University, Wroclaw, Poland
| | - Andrzej Gamian
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
| | - Mariola Paściak
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
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Toyoshima H, Tanigawa M, Nakamura K, Ishiguro C, Tanaka H, Nakanishi Y, Sakabe S. First case of Cutibacterium avidum-infected pelvic lymphocele post-lymphadenectomy for endometrial cancer: A case report. Heliyon 2023; 9:e21396. [PMID: 37920529 PMCID: PMC10618815 DOI: 10.1016/j.heliyon.2023.e21396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023] Open
Abstract
Background Pelvic lymphocele (lymphocyst) infection after lymphadenectomy is a rare complication that can cause the spread of inflammation to neighboring organs whose microbiology is not well known. Cutibacterium avidum causes various infections. However, no case reports of C. avidum pelvic lymphocele infection are available; therefore, its clinical characteristics in pelvic lymphocele infections remain unknown. Case presentation A 38-year-old woman with obesity (body mass index: 38.1 kg/m2) and a history of pelvic lymphadenectomy and chemotherapy for endometrial cancer presented with worsening left lower quadrant (LLQ) pain with fever. Physical examination revealed decreased abdominal bowel sounds and tenderness on LLQ palpation with no signs of peritonitis. Computed tomography (CT) revealed an infected left pelvic lymphocele with inflammation spreading to the adjacent sigmoid colon. Following blood culture, ampicillin/sulbactam (2 g/1 g every 6 h) was administered intravenously. Anaerobic culture bottles revealed gram-positive rods on day 4 of incubation at 37 °C. No other disseminated foci were observed in enhanced whole-body CT and upon transthoracic echocardiography. The isolates grew aerobically and anaerobically on blood agar plates with strong hemolysis. The bacterium was identified as C. avidum using a combination of characteristic peak analysis with matrix-assisted laser desorption ionization (MALDI) and 16S rRNA gene sequencing. The patient was diagnosed with C. avidum pelvic lymphocele infection. Based on penicillin susceptibility, the patient was successfully treated with intravenous ampicillin/sulbactam and de-escalated with intravenous ampicillin (2 g every 6 h) for 10 days, followed by oral amoxicillin (2000 mg/day) for an additional 11 days without drainage. Conclusions C. avidum should be considered a causative microorganism of pelvic lymphocele infection. Peak analysis using MALDI and distinctive growth on blood agar plates are suitable for identifying C. avidum. Mild pelvic lymphocele caused by C. avidum can be treated with a short course of appropriate antimicrobial treatment without surgical intervention.
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Affiliation(s)
- Hirokazu Toyoshima
- Department of Infectious Diseases, Japanese Red Cross Ise Hospital, 1-471-2, Funae, Ise, Mie, 516-8512, Japan
- Infection Prevention and Control Office, Japanese Red Cross Ise Hospital, Ise, 516-8512, Japan
| | - Motoaki Tanigawa
- Department of Respiratory Medicine, Japanese Red Cross Ise Hospital, 1-471-2, Funae, Ise, Mie, 516-8512, Japan
| | - Kanako Nakamura
- Department of Medical Technology, Japanese Red Cross Ise Hospital, 1-471-2, Funae, Ise, Mie, 516-8512, Japan
| | - Chiaki Ishiguro
- Infection Prevention and Control Office, Japanese Red Cross Ise Hospital, Ise, 516-8512, Japan
- Department of Medical Technology, Japanese Red Cross Ise Hospital, 1-471-2, Funae, Ise, Mie, 516-8512, Japan
| | - Hiroyuki Tanaka
- Department of Infectious Diseases, Japanese Red Cross Ise Hospital, 1-471-2, Funae, Ise, Mie, 516-8512, Japan
| | - Yuki Nakanishi
- Department of Infectious Diseases, Japanese Red Cross Ise Hospital, 1-471-2, Funae, Ise, Mie, 516-8512, Japan
| | - Shigetoshi Sakabe
- Department of Infectious Diseases, Japanese Red Cross Ise Hospital, 1-471-2, Funae, Ise, Mie, 516-8512, Japan
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Cunningham SA, Rodriguez C, Woerther PL, Menigaux C, Bauer T, Herrmann JL, Rottman M, Roux AL, Gaillard JL, Patel R, El Sayed F. In Vivo Emergence of Dual Resistance to Rifampin and Levofloxacin in Osteoarticular Cutibacterium avidum. Microbiol Spectr 2023; 11:e0368722. [PMID: 37289061 PMCID: PMC10434181 DOI: 10.1128/spectrum.03687-22] [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: 09/12/2022] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
Cutibacterium avidum is an emerging causative agent of orthopedic device-related infections (ODRIs). There are no guidelines for the antimicrobial treatment of C. avidum ODRI, but oral rifampin is frequently used in combination with a fluoroquinolone following intravenous antibiotics. We describe the in vivo emergence of combined resistance to rifampin and levofloxacin in a C. avidum strain isolated from a patient with early-onset ODRI treated with debridement, antibiotic treatment, and implant retention (DAIR) using rifampin combined with levofloxacin as the oral treatment. Whole-genome sequencing of C. avidum isolates before and after antibiotic exposure confirmed strain identity and identified new mutations in rpoB and gyrA, leading to amino acid substitutions previously reported to be associated with resistance to rifampin (S446P) and fluoroquinolones (S101L), respectively, in other microbial agents, in the posttherapy isolate. Aside from the molecular insights reported here, this study highlights potential limitations of the combination of oral rifampin and levofloxacin in patients undergoing a DAIR procedure for C. avidum ODRI and the potential need to evaluate specific optimal therapy for emerging ODRI pathogens. IMPORTANCE In this study, we report for the first time the in vivo emergence of dual resistance to levofloxacin and rifampin in C. avidum isolated from a patient who received both antibiotics orally in the setting of a salvage debridement and implant retention of an ODRI. Aside from the molecular insights reported here, this study highlights potential limitations of the combination of oral rifampin and levofloxacin in patients undergoing these surgical procedures and the potential need to evaluate specific optimal therapy for emerging ODRI pathogens.
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Affiliation(s)
- Scott A. Cunningham
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Christophe Rodriguez
- NGS Platform, IMRB, CHU Henri Mondor, Créteil, France
- Institut Mondor de Recherche Biomédicale, Inserm U955, Créteil, France
| | - Paul-Louis Woerther
- NGS Platform, IMRB, CHU Henri Mondor, Créteil, France
- Institut Mondor de Recherche Biomédicale, Inserm U955, Créteil, France
| | - Christophe Menigaux
- APHP, GHU Paris Saclay, Hôpital Ambroise Paré, Orthopedic Surgery Department, Boulogne-Billancourt, France
| | - Thomas Bauer
- APHP, GHU Paris Saclay, Hôpital Ambroise Paré, Orthopedic Surgery Department, Boulogne-Billancourt, France
| | - Jean-Louis Herrmann
- APHP, GHU Paris Saclay, Hôpital Raymond Poincaré, Microbiology Department, Garches, France
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-Le-Bretonneux, France
| | - Martin Rottman
- APHP, GHU Paris Saclay, Hôpital Raymond Poincaré, Microbiology Department, Garches, France
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-Le-Bretonneux, France
| | - Anne-Laure Roux
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-Le-Bretonneux, France
- APHP, GHU Paris Saclay, Hôpital Ambroise Paré, Microbiology Department, Boulogne-Billancourt, France
| | - Jean-Louis Gaillard
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-Le-Bretonneux, France
- APHP, GHU Paris Saclay, Hôpital Ambroise Paré, Microbiology Department, Boulogne-Billancourt, France
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Faten El Sayed
- Université Paris-Saclay, UVSQ, Inserm, Infection et Inflammation, Montigny-Le-Bretonneux, France
- APHP, GHU Paris Saclay, Hôpital Ambroise Paré, Microbiology Department, Boulogne-Billancourt, France
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Koizumi J, Nakase K, Hayashi N, Nasu Y, Hirai Y, Nakaminami H. Multidrug-resistant Cutibacterium avidum isolated from patients with acne vulgaris and other infections. J Glob Antimicrob Resist 2022; 28:151-157. [PMID: 35017069 DOI: 10.1016/j.jgar.2021.12.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 12/14/2021] [Accepted: 12/27/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Cutibacterium avidum, a human skin bacterium, rarely causes infectious diseases. It has been recently shown that C. acnes, another member of the genus Cutibacterium, acts as an opportunistic pathogen in surgical site infections. However, the antimicrobial susceptibility and pathogenicity of C. avidum remain unknown. Here, we investigated the epidemiological features of C. avidum. RESULTS C. avidum strains were isolated from patients with acne vulgaris (29 strains) and patients with other infections (12 strains). Antimicrobial susceptibility testing showed clarithromycin and clindamycin resistance in 65.9% of the tested strains (27/41). In addition, ciprofloxacin resistance was found in 34.1% of the strains (14/41), and 13 of those strains additionally exhibited resistance to both macrolides and clindamycin. Notably, the macrolides-clindamycin resistance gene erm(X) was found on the chromosomes of 92.6% (25/27) of the clindamycin-resistant strains and may be prevalent owing to transmission among C. avidum strains. Ciprofloxacin-resistant strains developed amino acid substitutions in GyrA owing to the use of antimicrobial agents. Pulsed-field gel electrophoresis (PFGE) analysis revealed that only a few strains exhibited 100% similarity. Additionally, no clustering associated with antimicrobial resistance, biofilm-forming ability, and type of infection was observed. CONCLUSIONS Our study revealed that erm(X) may be frequently disseminated in C. avidum, and multidrug-resistant C. avidum strains may colonize the skin of patients with acne vulgaris and patients with other infections. Therefore, the prevalence of multidrug-resistant C. avidum and the use of antimicrobial agents for the treatment of acne vulgaris and other infections associated with C. avidum should be monitored.
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Affiliation(s)
- Juri Koizumi
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
| | - Keisuke Nakase
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan.
| | - Nobukazu Hayashi
- Department of Dermatology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan
| | - Yutaka Nasu
- Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0944, Japan
| | - Yuji Hirai
- Department of Infectious Diseases, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0944, Japan
| | - Hidemasa Nakaminami
- Department of Clinical Microbiology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1 Horinouchi, Hachioji, Tokyo 192-0392, Japan
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Gussago S, Elzi L, Arigoni M, Poroli Bastone C, Molina MN. Simultaneous Propionibacterium avidum and Propionibacterium acnes Chronic Periprosthetic Hip Joint Infection: A Case Report. Cureus 2021; 13:e20771. [PMID: 35111456 PMCID: PMC8794411 DOI: 10.7759/cureus.20771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2021] [Indexed: 11/05/2022] Open
Abstract
Prosthetic hip joint replacement is considered the operation of the 20th century because of its wide diffusion and good outcome. More than 1 million prostheses are implanted worldwide annually. Although hip arthroplasty is considered a safe procedure, different complications can occur in relation with surgery. Periprosthesic joint infection is the most feared for its morbidity for the patients, and for the economic costs it generates. Most surgical site infections after hip arthroplasty are related to frequent germs as Staphylococci or Enterobacteriaceae, while Propionibacterium infections are more rare and often challenging in diagnosis and therapy. We report a case of a 77-year-old diabetic overweight male patient who developed a periprosthetic hip infection due to P. avidum and P. acnes after a mini-invasive direct anterior approach. To our knowledge, this represents the first case of chronic periprosthetic hip joint co-infection.
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Ponraj D, Falstie-Jensen T, Jørgensen N, Ravn C, Brüggemann H, Lange J. Diagnosis of orthopaedic-implant-associated infections caused by slow-growing Gram-positive anaerobic bacteria - a clinical perspective. J Bone Jt Infect 2021; 6:367-378. [PMID: 34660180 PMCID: PMC8515996 DOI: 10.5194/jbji-6-367-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/13/2021] [Indexed: 12/21/2022] Open
Abstract
Slow-growing Gram-positive anaerobic bacteria (SGAB) such as Cutibacterium acnes are increasingly recognized as causative agents of implant-associated infections (IAIs) in orthopaedic surgeries. SGAB IAIs are difficult to diagnose because of their non-specific clinical and laboratory findings as well as the fastidious growth conditions required by these bacteria. A high degree of clinical suspicion and awareness of the various available diagnostic methods is therefore important. This review gives an overview of the current knowledge regarding SGAB IAI, providing details about clinical features and available diagnostic methodologies. In recent years, new methods for the diagnosis of IAI were developed, but there is limited knowledge about their usefulness in SGAB IAI. Further studies are required to determine the ideal diagnostic methodology to identify these infections so that they are not overlooked and mistakenly classified as aseptic failure.
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Affiliation(s)
| | - Thomas Falstie-Jensen
- Department of Orthopaedic Surgery, Aarhus University Hospital,
Aarhus, 8200, Denmark
| | | | - Christen Ravn
- Department of Orthopaedic Surgery, Lillebaelt Hospital, Kolding,
6000, Denmark
| | | | - Jeppe Lange
- Department of Clinical Medicine, Aarhus University, Aarhus, 8000,
Denmark
- Department of Orthopaedic Surgery, Horsens Regional Hospital,
Horsens, 8700, Denmark
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Maurer SM, Kursawe L, Rahm S, Prinz J, Zinkernagel AS, Moter A, Kuster SP, Zbinden R, Zingg PO, Achermann Y. Cutibacterium avidum resists surgical skin antisepsis in the groin-a potential risk factor for periprosthetic joint infection: a quality control study. Antimicrob Resist Infect Control 2021; 10:27. [PMID: 33522957 PMCID: PMC7852298 DOI: 10.1186/s13756-021-00883-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 01/05/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The skin commensal Cutibacterium avidum has been recognized as an emerging pathogen for periprosthetic joint infections (PJI). One currently assumes that the early occurring PJIs are a consequence of skin commensals contaminating the peri-implant tissue during surgery. We addressed whether standard skin antisepsis with povidone-iodine/alcohol before total hip arthroplasty (THA) is effective to eliminate colonizing bacteria with focus on C. avidum. METHODS In a single-center, prospective study, we screened all patients for skin colonizing C. avidum in the groin before THA. Only in the patients positive for C. avidum, we preoperatively repeated skin swabs after the first and third skin antisepsis and antibiotic prophylaxis. We also obtained dermis biopsies for microbiology and fluorescence in situ hybridization (FISH). RESULTS Fifty-one out of 60 patients (85%) were colonized on the skin with various bacteria, in particular with C. avidum in 12 out of 60. Skin antisepsis eliminated C. avidum in eight of ten (20%) colonized patients undergoing THA. Deeper skin (dermis) biopsies were all culture negative, but FISH detected single positive ribosome-rich C. avidum in one case near sweat glands. CONCLUSION Standard skin antisepsis was not effective to completely eliminate colonizing C. avidum on the skin in the groin of patients undergoing THA. Colonizing with C. avidum might pose an increased risk for PJI when considering a THA. Novel more effective antisepsis strategies are needed. Trial registration No clinical trial.
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Affiliation(s)
- Steven M Maurer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Laura Kursawe
- Institute of Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Rahm
- Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland
| | - Julia Prinz
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Annelies S Zinkernagel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Annette Moter
- Institute of Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland
| | - Patrick O Zingg
- Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland
| | - Yvonne Achermann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
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Białasek M, Miłobędzka A. Revealing antimicrobial resistance in stormwater with MinION. CHEMOSPHERE 2020; 258:127392. [PMID: 32947654 PMCID: PMC7297696 DOI: 10.1016/j.chemosphere.2020.127392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 05/17/2020] [Accepted: 06/10/2020] [Indexed: 05/14/2023]
Abstract
Discharge of urban stormwater containing organic matter, heavy metals and sometime human feces, to the natural aquatic reservoirs without any treatment is not only an environmental problem. It can lead to prevalence of antibiotic resistant bacteria in stormwater systems and transmission of antibiotic resistance genes to the environment. We performed antibiotic resistome identification and virus detection in stormwater samples from Stockholm, using publicly available metagenomic sequencing MinION data. A MinION platform offers low-cost, precise environmental metagenomics analysis. 37 groups of antibiotic resistant bacteria (ARB), 11 resistance types with 26 resistance mechanisms - antibiotic resistance genes (ARGs) giving tolerance to the aminoglycoside, beta-lactams, fosmidomycin, MLS, multidrug and vancomycin were identified using ARGpore pipeline. The majority of the identified bacteria species were related to the natural environment such as soil and were not dangerous to human. Alarmingly, human pathogenic bacteria carrying resistance to antibiotics currently used against them (Bordetella resistant to macrolides and multidrug resistant Propionibacterium avidum) were also found in the samples. Most abundant viruses identified belonged to Caudovirales and Herpesvirales and they were not carrying ARGs. Unlike the virome, resistome and ARB were not unique for stormwater sampling points. This results underline the need for extensive monitoring of the microbial community structure in the urban stormwater systems to assess antimicrobial resistance spread.
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Affiliation(s)
- Maciej Białasek
- Department of Cancer Biology, Institute of Biology, Warsaw University of Life Sciences, Nowoursynowska 159, 02-776, Warsaw, Poland; Department of Physiological Sciences, Faculty of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159, 02-776, Warsaw, Poland.
| | - Aleksandra Miłobędzka
- Department of Water Technology and Environmental Engineering, University of Chemistry and Technology Prague, Technická 5, 166 28, Prague 6, Czech Republic.
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Elkins JM, Dennis DA, Kleeman-Forsthuber L, Yang CC, Miner TM, Jennings JM. Cutibacterium colonization of the anterior and lateral thigh. Bone Joint J 2020; 102-B:52-56. [PMID: 32600208 DOI: 10.1302/0301-620x.102b7.bjj-2019-1606.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Of growing concern in arthroplasty is the emergence of atypical infections, particularly Cutibacterium (formerly Propionibacterium) sp. infections. Currently, the dermal colonization rate of Cutibacterium about the hip is unknown. Therefore, the aim of this study was to investigate colonization rates of Cutibacterium sp. at locations approximating anterior and posterolateral approaches to the hip joint. METHODS For this non-randomized non-blinded study, 101 adult patients scheduled for hip or knee surgery were recruited. For each, four 3 mm dermal punch biopsies were collected after administration of anaesthesia, but prior to antibiotics. Prebiopsy skin preparation consisted of a standardized preoperative 2% chlorhexidine skin cleansing protocol and an additional 70% isopropyl alcohol mechanical skin scrub immediately prior to biopsy collection. Two skin samples 10 cm apart were collected from a location approximating a standard direct anterior skin incision, and two samples 10 cm apart were collected from a lateral skin incision (suitable for posterior, direct-lateral, or anterolateral approaches). Samples were cultured for two weeks using a protocol optimized for Cutibacterium. RESULTS A total of 23 out of 404 cultures (collected from 101 patients) were positive for a microorganism, with a total of 22 patients having a positive culture (22%). Overall, 15 of the cultures in 14 patients were positive for Cutibacterium sp. (65%), of which Cutibacterium acnes comprised the majority (n = 13; 87%). Other isolated microorganisms include coagulase-negative Staphylococcus (n = 6), Clostridium (n = 1), and Corynebacterium (n = 1). Of all positive cultures, 15 were obtained from the anterior location (65%), of which seven (60%) were from the most proximal biopsy location. However, these findings were not statistically significant (anterior vs lateral, p = 0.076; proximal vs distal, p =0.238). CONCLUSION Approximately 14% (14/101) of the patients demonstrated a positive Cutibacterium colonization about the hip, the majority anteriorly. Given the high colonization rate of Cutibacterium, alternative skin preparations for total hip arthroplasty should be considered. Cite this article: Bone Joint J 2020;102-B(7 Supple B):52-56.
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Affiliation(s)
- Jacob M Elkins
- Colorado Joint Replacement, Denver, Colorado, USA.,University of Iowa Department of Orthopedics and Rehabilitation, Iowa City, Iowa, USA
| | - Douglas A Dennis
- University of Denver Department of Mechanical & Materials Engineering, Denver, Colorado, USA.,Department of Orthopaedics, University of Colorado School of Medicine, Denver, Colorado, USA.,Department of Biomedical Engineering, University of Tennessee, Knoxville, Tennessee, USA, Denver, Colorado
| | | | | | - Todd M Miner
- Colorado Joint Replacement, Denver, Colorado, USA
| | - Jason M Jennings
- Colorado Joint Replacement, Denver, Colorado, USA.,University of Denver Department of Mechanical & Materials Engineering, Denver, Colorado, USA
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11
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Khayyira AS, Rosdina AE, Irianti MI, Malik A. Simultaneous profiling and cultivation of the skin microbiome of healthy young adult skin for the development of therapeutic agents. Heliyon 2020; 6:e03700. [PMID: 32337379 PMCID: PMC7176942 DOI: 10.1016/j.heliyon.2020.e03700] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/03/2020] [Accepted: 03/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background Studies on the impact of the skin microbiota on human health have been gaining more attention. Bacteria are associated with various diseases, although certain strains of bacteria, which are known as probiotics, are considered beneficial. Mixtures of several bacteria (bacterial cocktail) isolated from targeted organs have shown promising modulatory activities for use in skin therapeutics. The objectives of this study were to determine and identify the microbial communities on the skin that can potentially be used as probiotics, as determined by bacterial isolation and cultivation, followed by next-generation sequencing (NGS). Results Samples were collected by swabbing on forehead and cheek skin. Genomic DNA from bacterial swab samples were directly extracted to be further processed into NGS. Cultivation of skin bacteria was carried out in subsequent medium. Thus, around twenty bacterial isolates with different characteristics were selected and identified by both culture-based method and 16sRNA sequencing. We found that Actinobacteria and Firmicutes are the most abundant phylum present on the skin as presented by NGS data, which constitute to 67% and 28.59% of the whole bacterial population, consecutively. However, Staphylococcus hominis, Staphylococcus warneri, and Micrococcus luteus (AN MK968325.1; AN MK968315.1; and MK968318.1 respectively) were able to be obtained in the samples of cultivable, and could be potentially developed as probiotics in skin microbiome therapeutic as well as for postbiotic formulation. Conclusion Skin microbiome is considered to provide several probiotics for skin therapeutic. However, some opportunistic pathogens were discovered in this study population. Thus, the promising formula of bacterial cocktail for skin microbiome therapeutic must be thoroughly elucidated to avoid unwanted species. Our study is the first human skin microbiome profile of Indonesia resulted from a Next Generation Sequencing as an effort to show a representative of tropical country profile.
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12
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Böni L, Kuster SP, Bartik B, Zbinden R, Zingg PO, Achermann Y. Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection. Clin Infect Dis 2019; 67:1878-1882. [PMID: 29746626 DOI: 10.1093/cid/ciy379] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/03/2018] [Indexed: 12/25/2022] Open
Abstract
Background An increase in the incidence of hip periprosthetic joint infections caused by Cutibacterium avidum has recently been detected after hip arthroplasty with an anterior surgical approach. We raised the question of whether skin colonization with C. avidum differs between the anterior and the lateral thigh as areas of surgical incision fields. Methods Between February and June 2017, we analyzed skin scrapings from the groin and the anterior and lateral thigh in patients undergoing a primary hip arthroplasty. We anaerobically cultured plated swab samples for Cutibacterium spp. for ≥7 days. Univariate logistic regression analysis was used to explore associations between body mass index (BMI) and colonization rate at different sites. Results Twenty-one of 65 patients (32.3%) were colonized with C. avidum at any site, mainly at the groin (n = 16; 24.6%), which was significantly higher at the anterior (n = 5; 7.7%; P = .009) or lateral (n = 6; 9.2%; P = .02) thigh. Patients colonized with C. avidum did not differ from noncolonized patients in age or sex, but their BMIs were significantly higher (30.1 vs 25.6 kg/m2, respectively; P = .02). Furthermore, increased BMI was associated with colonization at the groin (odds ratio per unit BMI increase, 1.15; 95% confidence interval; 1.03-1.29; P = .01). Conclusions The groin, rather than the anterior thigh, showed colonization for C. avidum in obese patients. Further studies are needed to evaluate current skin disinfection and draping protocols for hip arthroplasty, particularly in obese patients.
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Affiliation(s)
- Laura Böni
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich
| | - Stefan P Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich
| | - Bianka Bartik
- Department of Orthopedics, University Hospital Balgrist
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University of Zurich, Switzerland
| | | | - Yvonne Achermann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich
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13
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Achermann Y, Liu J, Zbinden R, Zingg PO, Anagnostopoulos A, Barnard E, Sutter R, Li H, McDowell A, Zinkernagel AS. Propionibacterium avidum: A Virulent Pathogen Causing Hip Periprosthetic Joint Infection. Clin Infect Dis 2019; 66:54-63. [PMID: 29020266 DOI: 10.1093/cid/cix665] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 07/30/2017] [Indexed: 02/01/2023] Open
Abstract
Background Propionibacteria are important members of the human skin microbiota, but are also opportunistic pathogens associated with periprosthetic joint infection (PJI). While the role of Propionibacterium acnes in PJI has been widely described, insight into the capacity of Propionibacterium avidum to cause PJI is limited. Methods An unusual cluster of 4 hip PJIs caused by P. avidum in one orthopedic center in 2015 prompted us to retrospectively identify and analyze clinical data related to previous P. avidum PJI cases (1997-2015). We also characterized the hemolytic and biofilm-producing capacity of our 4 clinical P. avidum strains isolated in 2015, and investigated their phylogenetic relationships by whole-genome sequencing. Results We 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 of 12 patients (50%) with available case histories were treated with an exchange of the prosthesis. In all but 1 of the 6 patients treated with debridement-retention of the prosthesis, treatment failed, thus requiring a 2-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 2 phylogenetic clusters highly related to P. avidum PJI strains isolated in Sweden. Conclusions We describe the largest series of P. avidum PJI predominantly located in the hip. Phylogenetic similarity of our P. avidum strains to PJI strains isolated elsewhere suggests that these invasive lineages may be common.
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Affiliation(s)
- Yvonne Achermann
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Jared Liu
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles
| | - Reinhard Zbinden
- Institute of Medical Microbiology, University Hospital Balgrist, University of Zurich, Switzerland
| | - Patrick O Zingg
- Departments of Orthopedics, University Hospital Balgrist, University of Zurich, Switzerland
| | - Alexia Anagnostopoulos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Emma Barnard
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles
| | - Reto Sutter
- Departments of Radiology, University Hospital Balgrist, University of Zurich, Switzerland
| | - Huiying Li
- Department of Molecular and Medical Pharmacology, Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California, Los Angeles
| | - Andrew McDowell
- Northern Ireland Centre for Stratified Medicine, Biomedical Sciences Research Institute, Altnagelvin Area Hospital, University of Ulster, Londonderry, United Kingdom
| | - Annelies S Zinkernagel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Switzerland
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14
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Legaria MC, Barberis C, Camporro J, Traglia GM, Famiglietti A, Stecher D, Vay CA. Intra-peritoneal abscess after an abdominal hysterectomy involving Cutibacterium avidum (former Propionibacterium avidum) highly resistant to clindamycin. Anaerobe 2019; 59:176-183. [PMID: 31254654 DOI: 10.1016/j.anaerobe.2019.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/20/2019] [Accepted: 06/24/2019] [Indexed: 10/26/2022]
Abstract
Cutibacterium avidum is a gram-positive anaerobic rod belonging to the cutaneous group of human bacteria with preferential colonization of sweat glands in moist areas. The microorganism rarely cause disease, generally delayed prosthetic joint infections (PJIs). We describe the second case of intraperitoneal abscess by C. avidum after an abdominal surgery in an obese female patient and the first case after a non-prosthetic abdominal surgery due to a highly clindamycin resistant strain in a patient with underling conditions. The patient was successfully treated with surgical drainage and beta-lactam antibiotics. Although rare and apparently non-pathogenic, C. avidum may be involved in infections, especially in some high-risk patients with obesity who have undergone surgical incision involving deep folder of the skin. The microorganism was identified by phenotypic methods, MALDI-TOF MS and 16S rRNA gene sequencing. Susceptibility test should be performed in C. avidum because high level resistance to clindamycin could be present. We present a literature review of C. avidum infections.
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Affiliation(s)
- M C Legaria
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina.
| | - C Barberis
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
| | - J Camporro
- Universidad de Buenos Aires. Facultad de Medicina, Hospital de Clínicas José de San Martín, Servicio de Infectología, Buenos Aires, Argentina
| | - G M Traglia
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
| | - A Famiglietti
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
| | - D Stecher
- Universidad de Buenos Aires. Facultad de Medicina, Hospital de Clínicas José de San Martín, Servicio de Infectología, Buenos Aires, Argentina
| | - C A Vay
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Hospital de Clínicas José de San Martín, Departamento de Bioquímica Clínica, Cátedra de Microbiología Clínica, Buenos Aires, Argentina
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15
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Rocha Martin VN, Lacroix C, Killer J, Bunesova V, Voney E, Braegger C, Schwab C. Cutibacterium avidum is phylogenetically diverse with a subpopulation being adapted to the infant gut. Syst Appl Microbiol 2019; 42:506-516. [PMID: 31128887 DOI: 10.1016/j.syapm.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/09/2019] [Accepted: 05/10/2019] [Indexed: 12/18/2022]
Abstract
The infant gut harbors a diverse microbial community consisting of several taxa whose persistence depends on adaptation to the ecosystem. In healthy breast-fed infants, the gut microbiota is dominated by Bifidobacterium spp.. Cutibacterium avidum is among the initial colonizers, however, the phylogenetic relationship of infant fecal isolates to isolates from other body sites, and C. avidum carbon utilization related to the infant gut ecosystem have been little investigated. In this study, we investigated the phylogenetic and phenotypic diversity of 28 C. avidum strains, including 16 strains isolated from feces of healthy infants. We investigated the in vitro capacity of C. avidum infant isolates to degrade and consume carbon sources present in the infant gut, and metabolic interactions of C. avidum with infant associated Bifidobacterium longum subsp. infantis and Bifidobacterium bifidum. Isolates of C. avidum showed genetic heterogeneity. C. avidum consumed d- and l-lactate, glycerol, glucose, galactose, N-acetyl-d-glucosamine and maltodextrins. Alpha-galactosidase- and β-glucuronidase activity were a trait of a group of non-hemolytic strains, which were mostly isolated from infant feces. Beta-glucuronidase activity correlated with the ability to ferment glucuronic acid. Co-cultivation with B. infantis and B. bifidum enhanced C. avidum growth and production of propionate, confirming metabolic cross-feeding. This study highlights the phylogenetic and functional diversity of C. avidum, their role as secondary glycan degraders and propionate producers, and suggests adaptation of a subpopulation to the infant gut.
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Affiliation(s)
- Vanesa Natalin Rocha Martin
- Laboratory of Food Biotechnology, Institute of Food, Nutrition and Health, ETH-Zurich, 8092 Zurich, Switzerland; Division of Gastroenterology and Nutrition, University Children's Hospital Zurich, 8032 Zurich, Switzerland
| | - Christophe Lacroix
- Laboratory of Food Biotechnology, Institute of Food, Nutrition and Health, ETH-Zurich, 8092 Zurich, Switzerland
| | - Jiri Killer
- Institute of Animal Physiology and Genetics, Academy of Sciences of the Czech Republic, Czech Republic
| | - Vera Bunesova
- Department of Microbiology, Nutrition and Dietetics, Czech University of Life Sciences Prague, Kamýcká 129, Prague 6, Suchdol 165 00, Czech Republic
| | - Evelyn Voney
- Laboratory of Food Biotechnology, Institute of Food, Nutrition and Health, ETH-Zurich, 8092 Zurich, Switzerland
| | - Christian Braegger
- Division of Gastroenterology and Nutrition, University Children's Hospital Zurich, 8032 Zurich, Switzerland
| | - Clarissa Schwab
- Laboratory of Food Biotechnology, Institute of Food, Nutrition and Health, ETH-Zurich, 8092 Zurich, Switzerland.
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16
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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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17
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Corvec S. Clinical and Biological Features of Cutibacterium (Formerly Propionibacterium) avidum, an Underrecognized Microorganism. Clin Microbiol Rev 2018; 31:e00064-17. [PMID: 29848774 PMCID: PMC6056840 DOI: 10.1128/cmr.00064-17] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
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. It can cause numerous infections, including but not limited to breast infections, skin abscesses, infective endocarditis, and device-related 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. Historically, it has been used for its ability to modulate the immune response and for its antitumor properties. Conventional microbial culture methods and identification processes allow for its accurate identification and characterization. Thanks to the modern omics tools used for phylogenomic approaches, understanding C. avidum pathogenesis (including host-bacterium interactions and virulence factor characterization) is becoming easier, allowing for more thorough molecular characterization. These analyses have revealed that 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. Numerous regions show the presence of phages and horizontal gene transfer. 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. A long-term treatment regimen with a combination of antibiotics is required to successfully eliminate the remaining adherent bacteria, particularly in the case of deep infections after debridement surgery.
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Affiliation(s)
- Stéphane Corvec
- CHU Nantes, Service de Bactériologie-Hygiène Hospitalière, Nantes, France
- CRCINA, INSERM, U1232, Université de Nantes, Nantes, France
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18
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Zeller VA, Letembet VA, Meyssonnier VA, Heym B, Ziza JM, Marmor SD. Cutibacterium (Formerly Propionibacterium) avidum: A Rare but Avid Agent of Prosthetic Hip Infection. J Arthroplasty 2018; 33:2246-2250. [PMID: 29544969 DOI: 10.1016/j.arth.2018.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 01/15/2018] [Accepted: 02/02/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Cutibacterium spp. (formerly Propionibacterium) are slow-growing cutaneous anaerobic commensals, rarely reported in prosthetic joint infections (PJIs). We describe epidemiological, clinical, biological, and radiological characteristics of 15 Cutibacterium avidum PJIs, their treatments, and outcomes. METHODS This study is an observational, monocenter study (January 2004 to April 2017), with comparison of C avidum vs Cutibacterium acnes (n = 40) PJI characteristics. RESULTS Among 1179 PJIs treated during the study period, 15 (1%) PJIs were due to C avidum (14 classified as late chronic and 1 as early postoperative). They involved only obese patients with hip arthroplasties (median age 65 years, body mass index 35 kg/m2). Twelve patients' PJIs developed after primary hip arthroplasty. Thirteen patients' last clean operation had used an anterior approach. Fourteen preoperative joint aspirate cultures yielded C avidum. The 14 chronic PJIs were treated with 1-stage exchange arthroplasty, the acute case with excision synovectomy. Antibiotic therapy was administered for 12 [6-13] weeks, intravenously for 4 [2-6] weeks. The most used first-line agents were intravenous clindamycin (n = 8) or cefazolin (n = 6). After median follow-up of 27 [3-136] months, 1 relapse occurred. Compared to C acnes PJI patients, those with C avidum PJIs were significantly younger, had higher body mass indices, had only hip involvement, and had more frequent anterior surgical approach. C acnes PJIs were more frequent after revision arthroplasty. CONCLUSION C avidum is a rare PJI agent occurring in a particular subpopulation. Joint aspiration is the key diagnostic tool. Our results suggest that PJI risk factors include obesity, primary hip arthroplasty, and anterior surgical approach. Efforts to prevent these infections in high-risk patients should be developed.
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Affiliation(s)
- Valérie A Zeller
- Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Service de Médecine Interne et Rhumatologie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Valérie-Anne Letembet
- Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Service de Médecine Interne et Rhumatologie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Vanina A Meyssonnier
- Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Service de Médecine Interne et Rhumatologie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Beate Heym
- Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Laboratoire de Biologie Médicale, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Jean-Marc Ziza
- Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Service de Médecine Interne et Rhumatologie, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Simon D Marmor
- Centre de Référence des Infections Ostéo-Articulaires Complexes, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Service de Chirurgie Osseuse et Traumatologique, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
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Heshiki Y, Dissanayake T, Zheng T, Kang K, Yueqiong N, Xu Z, Sarkar C, Woo PCY, Chow BKC, Baker D, Yan A, Webster CJ, Panagiotou G, Li J. Toward a Metagenomic Understanding on the Bacterial Composition and Resistome in Hong Kong Banknotes. Front Microbiol 2017; 8:632. [PMID: 28450856 PMCID: PMC5389987 DOI: 10.3389/fmicb.2017.00632] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/28/2017] [Indexed: 11/23/2022] Open
Abstract
Currency is possibly one of the main media transmitting pathogens and drug resistance due to its wide circulation in daily life. In this study, we made a comprehensive characterization of the bacterial community present on banknotes collected from different geographical regions of Hong Kong (HK) by performing in vitro characterization of the bacterial presence and resistome profile, as well as metagenomic analysis including microbial diversity, the prevalence of potential pathogens, the dissemination potential of antibiotic-resistance genes (ARGs), among others. When comparing the bacterial community of HK banknotes with other HK environmental samples, including water and marine sediment, we revealed that HK banknotes cover nearly 50% of total genera found in all the environmental samples, implying that banknotes harbor diverse bacteria originated from a variety of environments. Furthermore, the banknotes have higher abundance of potential pathogenic species (~5 times more) and ARGs (~5 times more) with higher dissemination potential (~48 times more) compared with other environmental samples. These findings unveiled the capabilities of this common medium of exchange to accommodate various bacteria, and transmit pathogens and antibiotic resistance. Furthermore, the observed independence of microbiome profile from the city's topological indices led us to formulate a hypothesis that due to their high circulation banknotes may harbor a homogenized microbiome.
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Affiliation(s)
- Yoshitaro Heshiki
- Systems Biology and Bioinformatics Group, School of Biological Sciences, Faculty of Sciences, University of Hong KongHong Kong, China
| | - Thrimendra Dissanayake
- Systems Biology and Bioinformatics Group, School of Biological Sciences, Faculty of Sciences, University of Hong KongHong Kong, China
| | - Tingting Zheng
- Systems Biology and Bioinformatics Group, School of Biological Sciences, Faculty of Sciences, University of Hong KongHong Kong, China
| | - Kang Kang
- Systems Biology and Bioinformatics Group, School of Biological Sciences, Faculty of Sciences, University of Hong KongHong Kong, China
| | - Ni Yueqiong
- Systems Biology and Bioinformatics Group, School of Biological Sciences, Faculty of Sciences, University of Hong KongHong Kong, China
| | - Zeling Xu
- School of Biological Sciences, Faculty of Science, University of Hong KongHong Kong, China
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong KongHong Kong, China
| | - Patrick C Y Woo
- Department of Microbiology, University of Hong KongHong Kong, Hong Kong.,State Key Laboratory of Emerging Infectious Diseases, University of Hong KongHong Kong, Hong Kong.,Research Centre of Infection and Immunology, University of Hong KongHong Kong, Hong Kong.,The Carol Yu Centre for Infection, University of Hong KongHong Kong.,Guangzhou Center for Disease Control and PreventionGuangzhou, China
| | - Billy K C Chow
- School of Biological Sciences, Faculty of Science, University of Hong KongHong Kong, China
| | - David Baker
- School of Biological Sciences, Faculty of Science, University of Hong KongHong Kong, China
| | - Aixin Yan
- School of Biological Sciences, Faculty of Science, University of Hong KongHong Kong, China
| | - Christopher J Webster
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong KongHong Kong, China
| | - Gianni Panagiotou
- Systems Biology and Bioinformatics Group, School of Biological Sciences, Faculty of Sciences, University of Hong KongHong Kong, China.,Department of Systems Biology and Bioinformatics, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knöll InstituteJena, Germany
| | - Jun Li
- Systems Biology and Bioinformatics Group, School of Biological Sciences, Faculty of Sciences, University of Hong KongHong Kong, China
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