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Journal of Shoulder and Elbow Surgery Sep 2020Cutibacterium acnes is a lipophilic, anaerobic, gram-positive bacillus that mainly colonizes the pilosebaceous glands of human skin. It has been implicated as the... (Review)
Review
Cutibacterium acnes is a lipophilic, anaerobic, gram-positive bacillus that mainly colonizes the pilosebaceous glands of human skin. It has been implicated as the leading cause of prosthetic joint infection (PJI) after shoulder arthroplasty. However, PJI caused by C acnes rarely manifests as overt clinical, laboratory, or imaging features. In fact, more than 40% of shoulders undergoing revision arthroplasty are likely to be culture positive. However, rates of infection following a positive culture can be as low as 5%. The purpose of this review was to put forth alternative explanations for this discordance between positive cultures and infection. We describe C acnes roles as a commensal, bystander, and/or contaminant organism; the role of cultures in diagnosis and other methods that may be more accurate; its existence in a shoulder microbiome; and the variable virulence of C acnes. C acnes is an important cause of shoulder PJI in some patients. However, there is a large body of literature that suggests other functions that need to be considered. Further research is needed to define the role of C acnes that is logically explained by all of the literature and not only some.
Topics: Antimicrobial Stewardship; Arthroplasty, Replacement, Shoulder; Gram-Positive Bacterial Infections; Humans; Propionibacterium acnes; Prosthesis-Related Infections; Shoulder Prosthesis; Skin
PubMed: 32499199
DOI: 10.1016/j.jse.2020.02.020 -
Orthopedics Jan 2020Cutibacterium (formerly called Propionibacterium) acnes is a human skin flora often implicated in orthopedic infections. The unique characteristics of this microorganism... (Review)
Review
Cutibacterium (formerly called Propionibacterium) acnes is a human skin flora often implicated in orthopedic infections. The unique characteristics of this microorganism make the diagnosis of infection difficult. The diagnosis often is made based on clinical evidence, radiographic signs, and laboratory and/or surgical findings combined. Treatment often involves both pharmacologic and surgical methods. In addition, formation of biofilms and increased resistance to drugs exhibited by the microorganism can require combined antimicrobial therapy. Prophylactic measures are particularly important, but no single method has been shown to fully eliminate the risk of C acnes infections. Previous reports have focused on C acnes infections involving surgical implants or after certain orthopedic procedures, particularly in the shoulder and spine. This article reviews current clinical, diagnostic, and treatment principles for C acnes in orthopedics in general. [Orthopedics. 2020; 43(1):52-61.].
Topics: Anti-Bacterial Agents; Gram-Positive Bacterial Infections; Humans; Orthopedic Procedures; Propionibacterium acnes; Surgical Wound Infection
PubMed: 31958341
DOI: 10.3928/01477447-20191213-02 -
Veterinary Sciences Jun 2024The objective of this study was to investigate the therapeutic effects of inactivated and lipopolysaccharide derived from cells in cats affected by feline...
The objective of this study was to investigate the therapeutic effects of inactivated and lipopolysaccharide derived from cells in cats affected by feline panleukopenia virus (FPV). A retrospective study of 80 FPV-positive cats was divided into two groups: a treatment group receiving inactivated and lipopolysaccharide derived from cells along with supportive treatment and a no-treatment group receiving only supportive treatment. There was no significant difference in the total white blood cell counts between the two groups. However, the total white blood cell counts of both groups were low on day 0 and increased significantly on days 3 and 6 of treatment. Additionally, the white blood cell counts in the treatment group significantly increased during days 3 to 6 compared with those of the no-treatment group ( < 0.01). The mortality rate was not significantly different between the two groups. In a prospective study, the serum and fecal immunoglobulin A (IgA) levels were measured in both groups. There were no significant differences in IgA levels between the two groups in either the serum or feces.
PubMed: 38922001
DOI: 10.3390/vetsci11060253 -
Journal of Clinical Medicine Mar 2021Sarcoidosis may have more than a single causative agent, including infectious and non-infectious agents. Among the potential infectious causes of sarcoidosis, and are... (Review)
Review
Sarcoidosis may have more than a single causative agent, including infectious and non-infectious agents. Among the potential infectious causes of sarcoidosis, and are the most likely microorganisms. Potential latent infection by both microorganisms complicates the findings of molecular and immunologic studies. Immune responses to potential infectious agents of sarcoidosis should be considered together with the microorganisms detected in sarcoid granulomas, because immunologic reactivities to infectious agents reflect current and past infection, including latent infection unrelated to the cause of the granuloma formation. Histopathologic data more readily support as a cause of sarcoidosis compared with , suggesting that normally symbiotic leads to granuloma formation in some predisposed individuals with Th1 hypersensitivity against intracellular proliferation of latent , which may be triggered by certain host or drug-induced conditions. Detection of bacterial nucleic acids in granulomas does not necessarily indicate co-localization of the bacterial proteins in the granulomas. In the histopathologic diagnosis of sarcoidosis, -associated and -associated sarcoidosis will possibly be differentiated in some patients by immunohistochemistry with appropriate antibodies that specifically react with mycobacterial and propionibacterial antigens, respectively, for each etiology-based diagnosis and potential antimicrobial intervention against sarcoidosis.
PubMed: 33801218
DOI: 10.3390/jcm10050983 -
The British Journal of Dermatology Oct 2019The role of skin microbiota in acne remains to be fully elucidated. Initial culture-based investigations were hampered by growth rate and selective media bias. Even with... (Review)
Review
BACKGROUND
The role of skin microbiota in acne remains to be fully elucidated. Initial culture-based investigations were hampered by growth rate and selective media bias. Even with less biased genomic methods, sampling, lysis and methodology, the task of describing acne pathophysiology remains challenging. Acne occurs in sites dominated by Cutibacterium acnes (formerly Propionibacterium acnes) and Malassezia species, both of which can function either as commensal or pathogen.
OBJECTIVES
This article aims to review the current state of the art of the microbiome and acne.
METHODS
The literature regarding the microbiome and acne was reviewed.
RESULTS
It remains unclear whether there is a quantitative difference in microbial community distribution, making it challenging to understand any community shift from commensal to pathogenic nature. It is plausible that acne involves (i) change in the distribution of species/strains, (ii) stable distribution with pathogenic alteration in response to internal (intermicrobe) or external stimuli (host physiology or environmental) or (iii) a combination of these factors.
CONCLUSIONS
Understanding physiological changes in bacterial species and strains will be required to define their specific roles, and identify any potential intervention points, in acne pathogenesis and treatment. It will also be necessary to determine whether any fungal species are involved, and establish whether they play a significant role. Further investigation using robust, modern analytic tools in longitudinal studies with a large number of participants, may make it possible to determine whether the microbiota plays a causal role, is primarily involved in exacerbation, or is merely a bystander. It is likely that the final outcome will show that acne is the result of complex microbe-microbe and community-host interplay.
Topics: Acne Vulgaris; Humans; Malassezia; Microbiota; Propionibacterium acnes; Skin; Symbiosis
PubMed: 31342510
DOI: 10.1111/bjd.18230 -
The Journal of Antimicrobial... Oct 2020To establish testing and treatment recommendations for a ceftriaxone once-daily dose regimen for systemic infections with Cutibacterium acnes. (Review)
Review
OBJECTIVES
To establish testing and treatment recommendations for a ceftriaxone once-daily dose regimen for systemic infections with Cutibacterium acnes.
METHODS
A review of the literature and a retrospective evaluation of patients diagnosed with C. acnes spondylodiscitis and treated with ceftriaxone were performed. Ceftriaxone and penicillin MICs were determined for C. acnes isolates from blood and biopsies and the epidemiological cut-off (ECOFF) was determined with surveillance data from the UK Anaerobe Reference Laboratory in Cardiff.
RESULTS
Limited clinical data exist from endocarditis and prosthetic joint infections using treatment with ceftriaxone 2 g once daily for C. acnes with ceftriaxone MICs ≤0.5 mg/L. In this case study, five patients were successfully treated with ceftriaxone as part of the treatment for spondylodiscitis with C. acnes. Ceftriaxone and penicillin MICs of the C. acnes isolates from the patients were 0.016-0.125 mg/L and 0.012-0.032 mg/L, respectively. The ceftriaxone ECOFF was 0.5 mg/L and the penicillin ECOFF was 0.25 mg/L based on available surveillance data.
CONCLUSIONS
From the data presented in this study it would be acceptable to consider treatment with a once-daily dose of ceftriaxone 2 g for systemic infections, including endocarditis, spondylodiscitis and prosthetic joint infections with C. acnes using a clinical breakpoint of ≤0.5 mg/L (the ECOFF). However, clinical data are still limited and the response of patients treated with ceftriaxone for serious infections with C. acnes should be monitored closely.
Topics: Ceftriaxone; Discitis; Gram-Positive Bacterial Infections; Humans; Propionibacterium acnes; Retrospective Studies
PubMed: 32591800
DOI: 10.1093/jac/dkaa259 -
The Spine Journal : Official Journal of... Jun 2020Cutibacterium acnes (C. acnes) is associated with infection following shoulder and spine surgery due to follicular pore concentrations in these anatomic regions. It has...
BACKGROUND
Cutibacterium acnes (C. acnes) is associated with infection following shoulder and spine surgery due to follicular pore concentrations in these anatomic regions. It has been established that it can form biofilms on surgical implant materials, which may contribute to its role in perioperative infection, but its behavior of early colonization on those materials is not yet well understood.
PURPOSE
The purpose of this study was to evaluate the time to adherence and subsequent biofilm formation of C. acnes in the first 24 hours on implant materials commonly used in spinal surgery.
STUDY DESIGN
We compared the colonization and behavior of C. acnes over time when applied to five commonly used spine implant materials - polyether ether ketone (PEEK), cobalt chromium (CC), stainless steel (SS), titanium, and titanium alloy.
METHODS
C. acnes was applied onto the samples of PEEK, CC, SS, titanium, and titanium alloy, and allowed to adhere for periods of 4, 8, 12, 16, and 20 hours. Nonadherent bacteria were then washed from the samples. These samples were then allowed to continue incubating for a total 24 hours. Scanning electron microscopy and confocal laser scanning microscopy were used to visualize all samples for the presence and quantification of C. acnes adherence at each time period. Subsequent transition to biofilm formation on these samples was assessed via scanning electron microscopy at each time period.
RESULTS
The PEEK specimens exhibited the highest amount of surface biological burden in the first 24 hours compared with the other materials, which displayed little or no adherence. Rapid biofilm formation first observed at 8 hours of allowed adhesion on PEEK, whereas no significant biofilm formation was seen on the other materials during the observed time period.
CONCLUSIONS
Although C. acnes is known to have a slow proliferation rate, the results of this investigation demonstrate that it can rapidly adhere to and form a biofilm on PEEK. These data suggest that the use of PEEK implants placed during spinal surgery may facilitate early intraoperative colonization, and subsequent infection, compared with metallic implants.
CLINICAL SIGNIFICANCE
The findings of this study suggest that PEEK may prove to be problematic as a choice of implant material in cases were C. acnes infection is a possibility.
Topics: Alloys; Biofilms; Humans; Propionibacterium acnes; Prostheses and Implants; Spine; Titanium
PubMed: 31972305
DOI: 10.1016/j.spinee.2020.01.001 -
The British Journal of Cardiology 2022, previously known as , is a rare cause of infective endocarditis (IE). We provide a review of the literature and describe two recent cases from a single centre to... (Review)
Review
, previously known as , is a rare cause of infective endocarditis (IE). We provide a review of the literature and describe two recent cases from a single centre to provide insight into the various clinical presentations, progression and management of patients with this infection. The primary objective of our review is to highlight the difficulty in the initial assessment of these patients with an aim to improve the time and accuracy of diagnosis and expedite subsequent treatment. There are currently no guidelines in the literature specific to the management of IE caused by C. . Our secondary objectives are to disseminate information about the indolent course of the disease and add to the growing body of evidence around this rare, yet complex, cause of IE.
PubMed: 36873726
DOI: 10.5837/bjc.2022.025 -
MSphere Jan 2020Porphyrins are intermediate metabolites in the biosynthesis of vital molecules, including heme, cobalamin, and chlorophyll. Bacterial porphyrins are known to be... (Comparative Study)
Comparative Study
Porphyrins are intermediate metabolites in the biosynthesis of vital molecules, including heme, cobalamin, and chlorophyll. Bacterial porphyrins are known to be proinflammatory, with high levels linked to inflammatory skin diseases. species are dominant skin commensals and play essential roles in defending against pathogens and in triggering an inflammatory response. To better understand how the inflammatory potential of the skin microbiome may vary depending on its propionibacterial composition, we compared the production levels of porphyrins among , , , and strains. We found that porphyrin production varied among these species, with type I strains producing significantly larger amounts of porphyrins than type II and III strains and other species. strains that are highly associated with the common skin condition acne vulgaris responded to vitamin B supplementation with significantly higher porphyrin production. In contrast, vitamin B supplementation had no effect on the porphyrin production of health-associated strains and other propionibacteria. We observed low-level porphyrin production in most strains harboring the repressor gene, with the exception of strains belonging to type I clades IB-3 and IC. Our findings shed light on the proinflammatory potential of distinct phylogenetic lineages of as well as other resident skin propionibacteria. We demonstrate that the overall species and strain composition is important in determining the metabolic output of the skin microbiome in health and disease. Porphyrins are a group of metabolites essential to the biosynthesis of heme, cobalamin, and chlorophyll in living organisms. Bacterial porphyrins can be proinflammatory, with high levels linked to human inflammatory diseases, including the common skin condition acne vulgaris. Propionibacteria are among the most abundant skin bacteria. Variations in propionibacteria composition on the skin may lead to different porphyrin levels and inflammatory potentials. This study characterized porphyrin production in all lineages of , the most dominant skin , and other resident skin propionibacteria, including , , and We revealed that type I strains produced significantly more porphyrins than did type II and III strains and other species. The findings from this study shed light on the proinflammatory potential of the skin microbiome and can be used to guide the development of effective acne treatments by modulating the skin microbiome and its metabolic activities.
Topics: Humans; Microbiota; Phylogeny; Porphyrins; Propionibacteriaceae; Propionibacterium; Propionibacterium acnes; Skin
PubMed: 31941813
DOI: 10.1128/mSphere.00793-19 -
Experimental Dermatology Oct 2021Cutibacterium acnes (also known as Propionibacterium acnes) has long been implicated in the pathogenesis of acne, inspiring both therapeutic and personal care approaches...
Cutibacterium acnes (also known as Propionibacterium acnes) has long been implicated in the pathogenesis of acne, inspiring both therapeutic and personal care approaches aiming to control the disease by controlling the bacterium. The purported association has made people with acne feel dirty and led to the-at times excessive-use of cleansers, antiseptics and antibiotics for the condition. However, recent evidence seems to weaken the case for C. acnes' involvement. New genetics and molecular biology findings strongly suggest that abnormal differentiation of sebaceous progenitor cells causes comedones, the primary lesions in acne. Comodegenesis is initiated by androgens and is unlikely to be triggered by C. acnes, which probably doesn't affect sebaceous differentiation. Is there still a place for it in this understanding of acne? It is necessary to critically address this question because it has consequences for treatment. Antibiotic use for acne noticeably contributes to microbial drug resistance, which we can ill afford. In this Viewpoint, we explore if and how C. acnes (still) fits into the developing view on acne. We also briefly discuss the implications for therapy in the light of antibiotic resistance and the need for more targeted therapies.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Propionibacterium acnes; Sebum
PubMed: 34009698
DOI: 10.1111/exd.14394