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The Bone & Joint Journal May 2021Periprosthetic joint infections (PJIs) are among the most devastating complications after joint arthroplasty. There is limited evidence on the efficacy of different...
AIMS
Periprosthetic joint infections (PJIs) are among the most devastating complications after joint arthroplasty. There is limited evidence on the efficacy of different antiseptic solutions on reducing biofilm burden. The purpose of the present study was to test the efficacy of different antiseptic solutions against clinically relevant microorganisms in biofilm.
METHODS
We conducted an in vitro study examining the efficacy of several antiseptic solutions against clinically relevant microorganisms. We tested antiseptic irrigants against nascent (four-hour) and mature (three-day) single-species biofilm created in vitro using a drip-flow reactor model.
RESULTS
With regard to irrigant efficacy against biofilms, Povidone-iodine treatment resulted in greater reductions in nascent MRSA biofilms (logarithmic reduction (LR) = 3.12; p < 0.001) compared to other solutions. Bactisure treatment had the greatest reduction of mature biofilms (LR = 1.94; p = 0.032) and a larger reduction than Vashe or Irrisept for mature biofilms (LR = 2.12; p = 0.025). Pooled data for all biofilms tested resulted in Bactisure and Povidone-iodine with significantly greater reductions compared to Vashe, Prontosan, and Irrisept solutions (p < 0.001).
CONCLUSION
Treatment failure in PJI is often due to failure to clear the biofilm; antiseptics are often used as an adjunct to biofilm clearance. We tested irrigants against clinically relevant microorganisms in biofilm in vitro and showed significant differences in efficacy among the different solutions. Further clinical outcome data is necessary to determine whether these solutions can impact PJI outcome in vivo. Cite this article: 2021;103-B(5):908-915.
Topics: Acetic Acid; Anti-Bacterial Agents; Anti-Infective Agents, Local; Arthroplasty, Replacement; Benzalkonium Compounds; Betaine; Biguanides; Biofilms; Chlorhexidine; Hydrogen Peroxide; In Vitro Techniques; Methicillin-Resistant Staphylococcus aureus; Povidone-Iodine; Propionibacteriaceae; Prosthesis-Related Infections; Pseudomonas aeruginosa; Sodium Hypochlorite; Staphylococcus epidermidis
PubMed: 33934664
DOI: 10.1302/0301-620X.103B5.BJJ-2020-1245.R2 -
Critical Reviews in Biotechnology Dec 2022Propionic acid (PA) is a carboxylic acid applied in a variety of processes, such as food and feed preservative, and as a chemical intermediate in the production of... (Review)
Review
Propionic acid (PA) is a carboxylic acid applied in a variety of processes, such as food and feed preservative, and as a chemical intermediate in the production of polymers, pesticides and drugs. PA production is predominantly performed by petrochemical routes, but environmental issues are making it necessary to use sustainable processes based on renewable materials. PA production by fermentation with the genus is a promising option in this scenario, due to the ability of this genus to consume a variety of renewable carbon sources with higher productivity than other native microorganisms. However, fermentation processes present important challenges that must be faced to make this route competitive, such as: a high fermentation time, product inhibition and low PA final titer, which increase the cost of product recovery. This article summarizes the state of the art regarding strategies to improve PA production by fermentation with the genus. Firstly, strategies associated with environmental fermentation conditions and nutrition requirements are discussed. Subsequently, advantages and disadvantages of various strategies proposed to improve process performance (high cell concentration by immobilization or recycle, co-culture fermentation, genome shuffling, evolutive and metabolic engineering, and recovery) are evaluated.
Topics: Propionibacterium; Fermentation; DNA Shuffling; Propionates
PubMed: 35264026
DOI: 10.1080/07388551.2021.1995695 -
Journal of Cosmetic Dermatology Dec 2021Topical and oral antibiotic therapy is also a popular method of treatment. The effectiveness of this method is limited by the increasing resistance of bacteria to... (Review)
Review
Topical and oral antibiotic therapy is also a popular method of treatment. The effectiveness of this method is limited by the increasing resistance of bacteria to antibiotics. Over the decades since the introduction of antibiotics to treat acne, the resistance levels of bacteria have changed. This defense mechanism is developed evolutionarily. Modifications of antibiotic receptor sites, alteration of drug influx/efflux, or enzymatic degradation are common mechanisms used by bacteria to initiate and strengthen internal antibiotic resistance. The basic chromophores used in light therapy are hemoglobin, melanin, water bound to proteins, and porphyrins. Hemoglobin absorbs light mainly at 580 nm, while melanin absorbs the entire visible spectral range (400-750 nm). Porphyrins are aromatic compounds, classified as photosensitizing substances, intensively absorbing blue light, and to a lesser extent in long visible bands, such as orange and red light. Using IPL makes it possible to cover the maximum light absorption of porphyrins and hemoglobin, therefore it can be an effective tool in the treatment of inflammatory lesions in acne vulgaris. In view of the effectiveness of light therapy and its effect even on antibiotic-resistant bacteria, it is worth considering the possibility of using light therapy instead of antibiotic therapy. Due to the increasing resistance of bacteria to antimicrobials, they should be used with caution and as a last resort. The high-energy light treatment act only locally (unlike with antibiotics taken orally) and on a chromophore, such as melanin, hemoglobin, or porphyrins.
Topics: Acne Vulgaris; Administration, Oral; Anti-Bacterial Agents; Humans; Phototherapy; Propionibacterium acnes
PubMed: 34674364
DOI: 10.1111/jocd.14506 -
APMIS : Acta Pathologica,... Dec 2021Post-surgical infections arise due to various contributing factors. Most important is the presence of potential pathogenic microorganisms in the skin complemented by the... (Review)
Review
Post-surgical infections arise due to various contributing factors. Most important is the presence of potential pathogenic microorganisms in the skin complemented by the patient´s health status. Cutibacterium acnes is commonly present in the pilosebaceous glands and hair follicle funnels in human skin. After surgical intervention, these highly prevalent, slow-growing bacteria can be found in the deeper tissues and in proximity of implants. C. acnes is frequently implicated in post-surgical infections, often resulting in the need for revision surgery. This review summarizes the current understanding of microbial dynamics in shoulder surgical infections. In particular, we shed light on the contribution of C. acnes to post-surgical shoulder infections as well as their colonization and immune-modulatory potential. Despite being persistently found in post-surgical tissues, C. acnes is often underestimated as a causative organism due to its slow growth and the inefficient detection methods. We discuss the role of the skin environment constituted by microbial composition and host cellular status in influencing C. acnes recolonization potential. Future mapping of the individual skin microbiome in shoulder surgery patients using advanced molecular methods would be a useful approach for determining the risk of post-operative infections.
Topics: Gram-Positive Bacterial Infections; Humans; Microbiota; Propionibacteriaceae; Shoulder; Skin; Surgical Wound Infection
PubMed: 34587324
DOI: 10.1111/apm.13185 -
PDA Journal of Pharmaceutical Science... 2020In the aseptic manufacture of parenteral drug products and low bioburden, cell, and gene therapy products, the control and monitoring of environmental- and... (Review)
Review
In the aseptic manufacture of parenteral drug products and low bioburden, cell, and gene therapy products, the control and monitoring of environmental- and personnel-associated microorganisms is an imperative for the confirmation of controlled conditions and the assessment of microbial risks. Environmental and personnel monitoring programs exist to assure product quality and serve as one of the several means of removing the emphasis on finished drug product testing. Therefore, these programs must adequately assess these risks and identify situations in which increased microbial risks occur. The major source of microbial risks in the controlled clean room environments for parenteral drug product manufacture are personnel. Modern microbial analytical methods, including metagenomic analysis, have identified a greater abundance of ; traditional culture-based monitoring fails to consistently recover and assist in the identification of the potential risk that this microorganism represents. This review provides a case-study assessment of this microorganism in the context of parenteral manufacture for the purpose of assisting in the deciding the necessary controls and the potential monitoring addressing this microbial risk.
Topics: Drug Contamination; Environment, Controlled; Environmental Monitoring; Humans; Infusions, Parenteral; Microbiological Techniques; Patient Safety; Pharmaceutical Preparations; Propionibacteriaceae; Risk Assessment; Skin; Technology, Pharmaceutical
PubMed: 32060223
DOI: 10.5731/pdajpst.2019.010975 -
Expert Opinion on Emerging Drugs Mar 2015Acne is the most common skin condition in the US. The mainstay of acne therapy includes: topical retinoids, topical antibiotics, benzoyl peroxide (BP), and oral... (Review)
Review
INTRODUCTION
Acne is the most common skin condition in the US. The mainstay of acne therapy includes: topical retinoids, topical antibiotics, benzoyl peroxide (BP), and oral isotretinoin for severe cases. Although these treatment options are highly effective they do have certain drawbacks. Current acne treatment regimens often require patients to use multiple medications, some of which may have irritating side effects. Furthermore, Propionibacterium acnes resistance to antibiotics has become an increasing problem due to the rise in antibiotic use.
AREAS COVERED
New therapies that have either been released onto the market or that are being developed include: adapalene-BP combination agent, dapsone 5% gel, minocycline foam, topical nitric oxide-releasing agent, cortexolone 17 α-propionate, and CIP isotretinoin. Some of these new therapies address the challenges faced with existing treatment options. For instance, the relatively new combination therapy, adapalene-BP, limits antibiotic resistance and also helps simplify treatment regimens. The newly developed topical nitric oxide-releasing agent also holds potential in limiting antibiotic resistance.
EXPERT OPINION
Many of the new therapies discussed in this paper are still in early stages of testing so it is difficult to predict their outlook; however, based on preliminary findings, these therapies seem to be promising.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Dermatologic Agents; Drug Design; Drug Resistance, Bacterial; Humans; Propionibacterium acnes
PubMed: 25474485
DOI: 10.1517/14728214.2015.990373 -
Applied Microbiology and Biotechnology May 2021Propionibacterium freudenreichii is a beneficial food-grade actinobacterium, widely implemented, and thus consumed, in various food products. As the main application, P.... (Review)
Review
Propionibacterium freudenreichii is a beneficial food-grade actinobacterium, widely implemented, and thus consumed, in various food products. As the main application, P. freudenreichii is used as a cheese-ripening starter, mostly in hard type cheeses. Indeed, during manufacture of "Swiss-type" cheeses (or opened-body cheeses), the technological process favors propionibacteria growth, as well as the corresponding propionic fermentation. This leads to the characteristic flavor of these cheeses, through the release of short chain fatty acids and through lipolysis, as well as to their specific texture. To fulfil this ripening, massive amounts of propionibacteria are industrially produced, dried and stored, prior to cheese making. Furthermore, P. freudenreichii is commercialized in various probiotic food supplements aiming at preserving intestinal health and comfort, in line with its ability to produce beneficial metabolites (short chain fatty acids, vitamins), as well as immunomodulatory compounds. Other industrial applications of P. freudenreichii include the production of food-grade vitamins of the B group, of trehalose, of conjugated linoleic acid, and of biopreservatives. For these different applications, maintaining survival and activity of propionibacteria during production, drying, storage and finally implementation, is crucial. More widely, maintaining live and active probiotic bacteria represents a challenge as the market for probiotic products increases. Probiotic bacteria are, for a bulk majority, freeze-dried, but spray drying is also more and more considered. Indeed, this process is both continuous and more cost-efficient, as it utilizes less energy compared to freeze-drying; on the other hand, it exposes bacteria to higher heat and oxidative stresses. Apart from process optimization and strain selection, it is possible to enhance the resistance of bacteria by taking advantage of their adaptation capacity. Indeed, P. freudenreichii stress tolerance can be boosted by different pretreatments applied before the drying step, thus considerably increasing its final survival. In particular, adaptation to hyperosmotic conditions improves stress tolerance, while the presence of osmoprotectants may mitigate this improvement. Thermal adaptation also modulates tolerance towards these technological challenges. The composition of the growth medium, including the ratio between the carbohydrates provided and the non-protein nitrogen, plays a key role in driving the accumulation of osmoprotectants. This, in turn, determines P. freudenreichii tolerance towards different stresses, and overall towards both freeze-drying and spray-drying. As an example, the accumulation of trehalose enhances its spray-drying survival, while the accumulation of glycine betaine enhances its freeze-drying survival. Growth of propionibacteria in hyperconcentrated whey was used to trigger multiple stress tolerance acquisition, underpinned by overexpression of key stress protein, accumulation of cytoplasmic storage compounds, and leading to enhanced spray-drying survival. A simplified process, from cultivation to atomization, was developed by using whey as a 2-in-1 medium in which propionibacteria were grown, protected and dried with minimal cell death. This innovative process was then subjected to scaling up at the industrial level. In this aim, a gentle multi-stage drying process offering mild drying conditions by coupling spray drying with belt drying, led to final probiotic survival close to 100% when stress tolerance acquisition was previously implemented. Such innovation opens new avenues for the efficient, cost-effective and sustainable development of new probiotic production technologies, as well as probiotic application in the context of food and feed. KEY POINTS: • Propionibacteria acquire multi-stress tolerance when grown in hyper-concentrated whey. • Spray drying of osmo-adapted probiotic bacteria is possible with limited cell death. • A two-in-one drying method is developed to grow and dry probiotic bacteria in the same matrix.
Topics: Cheese; Desiccation; Food Microbiology; Probiotics; Propionibacterium; Propionibacterium freudenreichii; Whey
PubMed: 33885925
DOI: 10.1007/s00253-021-11273-3 -
Expert Review of Anti-infective Therapy Jul 2015Antibiotic resistance in cutaneous Propionobacterium is a global problem. As a general rule, resistance levels are high to macrolides, trimethoprim/sulfamethoxazole and... (Review)
Review
Antibiotic resistance in cutaneous Propionobacterium is a global problem. As a general rule, resistance levels are high to macrolides, trimethoprim/sulfamethoxazole and clindamycin, while tetracyclines and levofloxacin have low resistance potential. Newer preparations like doxycycline MR and doxycycline 20 mg are subantimicrobial and may not lead to resistance. Sampling techniques are crucial to determine resistance. Genomic evaluation using 16S ribosomal RNA gene sequencing can be useful in diagnosing mutations and mapping phylotypes of Propionobacterium acnes. Resistance may lead to slow response and relapses. Apart from benzoyl peroxide, azelaic acid, topical dapsone, oral zinc and retinoids, novel molecules with little resistance potential include octadecenedioic acid, phytosphingosine, lauric acid, retapamulin, resveratrol, T-3912 and NB-003. The use of oral retinoids and non-antibiotics like zinc can prevent resistance and help reduce the dependence on antibiotics.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Disease Management; Drug Resistance, Microbial; Global Health; Gram-Positive Bacterial Infections; Humans; Propionibacterium acnes
PubMed: 26025191
DOI: 10.1586/14787210.2015.1040765 -
Nature Reviews. Microbiology Mar 2024
Topics: Propionibacteriaceae; Skin
PubMed: 38238416
DOI: 10.1038/s41579-024-01011-7 -
Journal of the European Academy of... Apr 2020Acne fulminans (AF) is a rare and severe form of inflammatory acne. It is characterized by a sudden worsening of acne with appearance of ulceronecrotic lesions, which... (Observational Study)
Observational Study
BACKGROUND
Acne fulminans (AF) is a rare and severe form of inflammatory acne. It is characterized by a sudden worsening of acne with appearance of ulceronecrotic lesions, which can be associated with systemic signs. Its pathophysiology and the best therapeutic strategy are only partially known.
OBJECTIVE
Our main objectives were to describe the clinical and biological profile of AF patients and to determine whether there was a difference in Cutibacterium acnes phylotype in AF compared to acne vulgaris. The secondary objective was to assess the efficacy of different therapies.
METHODS
A retrospective observational study was conducted in all patients followed for AF in our department between 2008 and 2018. Bacteriological samples were taken from each patient to analyse C. acnes phylotype distribution. The therapeutic response was assessed using the ECLA and GEA scales.
RESULTS
Fifteen patients with a median age of 15 years were included (12 men, 80%). A family history of acne was found in 86.7% of patients. Nine patients (60%) had isotretinoin-induced AF. Only one patient (6.7%) showed systemic signs. The bacteriological culture was positive for C. acnes in 80% of patients. The predominant phylotype was IA1 in 60% of patients, corresponding to the predominant phylotype in acne vulgaris. Only 33.3% of patients were in remission after a first-line treatment with systemic corticosteroids, alone or in combination. Seven patients were treated with biotherapy, including five successfully with secukinumab.
CONCLUSION
Our results suggest that there is no specific C. acnes phylotype associated with AF, raising the hypothesis that acute inflammation associated with AF may be more related to an abnormal cutaneous innate immunity activation. The use of preventive strategies, the impact of combined treatments and an assessment of the role of biotherapies, especially anti-IL-17, in AF treatment remain to be more investigated.
Topics: Acne Vulgaris; Adolescent; Female; Humans; Male; Phylogeny; Propionibacteriaceae; Retrospective Studies; Skin
PubMed: 31715640
DOI: 10.1111/jdv.16064