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The British Journal of Dermatology Nov 2017Dysbiosis is a hallmark of atopic dermatitis (AD). The composition of skin microbiome communities and the causality of dysbiosis in eczema have not been well... (Review)
Review
Dysbiosis is a hallmark of atopic dermatitis (AD). The composition of skin microbiome communities and the causality of dysbiosis in eczema have not been well established. The objective of this review is to describe the skin microbiome profile in AD and address whether there is a causal relationship between dysbiosis and AD. The protocol is registered in PROSPERO (CRD42016035813). We searched PubMed, Embase, Scopus and ClinicalTrials.gov for primary research studies applying culture-independent analysis on the microbiome on AD skin of humans and animal models. Two authors independently screened the full text of studies for eligibility and assessed risk of bias. Because of heterogeneity no quantitative synthesis was done. Of 5735 texts, 32 met the inclusion criteria (17 published: 11 human and six animal studies). The studies varied in quality and applied different methodology. The skin in AD had low bacterial diversity (lowest at dermatitis-involved sites) and three studies showed depletion of Malassezia spp. and high non-Malassezia fungal diversity. The relative abundance of Staphylococcus aureus and Staphylococcus epidermidis were elevated and other genera were reduced, including Propionibacterium. A mouse study indicated that dysbiosis is a driving factor in eczema pathogenesis. The data are not sufficiently robust for good characterization; however, dysbiosis in AD not only implicates Staphylococcus spp., but also microbes such as Propionibacterium and Malassezia. A causal role of dysbiosis in eczema in mice should encourage future studies to investigate if this also applies to humans. Other important aspects are temporal dynamics and the influence of methodology on microbiome data.
Topics: Animals; Dermatitis, Atopic; Dermatologic Agents; Disease Models, Animal; Dogs; Humans; Mice; Microbiota
PubMed: 28207943
DOI: 10.1111/bjd.15390 -
Southern Medical Journal Feb 2005Bacterial spondylodiscitis is rarely caused by anaerobic organisms. We describe two patients with lumbar vertebral osteomyelitis and discitis caused by anaerobic... (Review)
Review
BACKGROUND
Bacterial spondylodiscitis is rarely caused by anaerobic organisms. We describe two patients with lumbar vertebral osteomyelitis and discitis caused by anaerobic bacteria, including an unusual occurrence after an endodontic procedure, and review the salient clinical features and outcomes of 31 previously reported cases.
METHODS
Case reports and review of the literature.
RESULTS
Median age at presentation was 65 years, with a male-to-female ratio of 2:1. The most common presenting symptoms were back pain, fever, and neurologic deficits. The lumbar spine was most frequently involved (43%); an equal number of cases involved contiguous extension or hematogenous spread. Causative anaerobes were recovered from disk space or vertebrae (13), blood (4), and/or soft tissue abscess and included Bacteroides species (12), Propionibacterium acnes (7), Peptococcus species (4), Peptostreptococcus species and Clostridium species (3 each), Corynebacterium diphtheroides and Fusobacterium species (2 each), and unspecified anaerobes (3).
CONCLUSIONS
Apart from specific antibiotic selection, medical treatment and outcomes for anaerobic spondylodiscitis are similar to those for aerobic vertebral disk infection.
Topics: Aged; Bacterial Infections; Discitis; Female; Humans; Lumbar Vertebrae; Male; Radiography
PubMed: 15759942
DOI: 10.1097/01.SMJ.0000129928.03804.2A -
Shoulder & Elbow Dec 2022() is the most common pathogen responsible for post-operative shoulder infections. The purpose of this study was to evaluate the effectiveness of skin preparation... (Review)
Review
BACKGROUND
() is the most common pathogen responsible for post-operative shoulder infections. The purpose of this study was to evaluate the effectiveness of skin preparation methods against in shoulder surgery.
METHODS
A systematic review was conducted evaluating the effectiveness of skin preparation methods in the reduction of in patients undergoing shoulder surgery. Outcomes were assessed based on the effectiveness of the method used; side effects and cost were also analysed.
RESULTS
Of the 19 included studies, 9 evaluated pre-surgical home treatments: 8 assessed benzoyl peroxide (BPO) and 6 concluded it is effective in reducing Nine studies assessed surgical skin preparation and concluded that Chlorhexidine gluconate (CHG) was not effective; in contrast hydrogen peroxide reduced . Finally, one study evaluated an aseptic protocol using CHG and concluded that it was not effective.
CONCLUSIONS
It was demonstrated that BPO as home treatment is effective in reducing load on skin it rarely causes side effects and is also cost-effective. This study highlights non-effectiveness of CHG. There was some evidence that the addition of hydrogen peroxide could have a positive effect in the reduction of skin load; however, more studies are required.
PubMed: 36479010
DOI: 10.1177/17585732211032523 -
Journal of Neurosurgical Sciences Apr 2019The aim of this paper was to systematically review the evidence linking Propionibacterium acnes (P. acnes) with the development of symptomatic degenerative disc disease.
BACKGROUND
The aim of this paper was to systematically review the evidence linking Propionibacterium acnes (P. acnes) with the development of symptomatic degenerative disc disease.
EVIDENCE ACQUISITION
Data were obtained from MEDLINE from their inception to October 2015. Two authors independently conducted the searches, extracted data and completed methodological quality assessments. Articles were included if they investigated the presence of P. acnes in symptomatic degenerative disc disease through intra-operative cultural examination. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale.
EVIDENCE SYNTHESIS
Overall 641 articles were retrieved with 9 cross-sectional studies being included in the review. All selected studies revealed an association between P. acnes and disc degeneration.
CONCLUSIONS
This study shows that there is a relationship between P. acnes and development of symptomatic degenerative disc disease. Despite this, we cannot support that P. acnes and development of symptomatic degenerative disc disease due to the low quality of the results according Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Topics: Adult; Gram-Positive Bacterial Infections; Humans; Intervertebral Disc Degeneration; Propionibacterium acnes
PubMed: 27603410
DOI: 10.23736/S0390-5616.16.03842-X -
Journal of Shoulder and Elbow Surgery Oct 2022Unexpected positive cultures (UPCs) are very commonly found during shoulder arthroplasty when surgeons send intraoperative cultures to rule out periprosthetic joint... (Review)
Review
BACKGROUND
Unexpected positive cultures (UPCs) are very commonly found during shoulder arthroplasty when surgeons send intraoperative cultures to rule out periprosthetic joint infection (PJI) without clinical or radiographic signs of infection. Cutibacterium acnes is thought to be the most common bacteria cultured in this setting; however, the implications of an unexpected positive result are neither well defined nor agreed upon within the literature. The current review evaluates the incidence of UPCs and C acnes in reverse total arthroplasty; the clinical significance, if any, of these cultures; and various prognostic factors that may affect UPC incidence or recovery following PJI.
METHODS
A systematic review was performed with PRISMA guidelines using PubMed, CINAHL, and Scopus databases. Inclusion criteria included studies published from January 1, 2000, to May 20, 2021, that specifically reported on UPCs, native or revision shoulder surgery, and any study that directly addressed one of our 6 proposed clinical questions. Two independent investigators initially screened 267 articles for further evaluation. Data on study design, UPC rate/speciation, UPC risk factors, and UPC outcomes were analyzed and described.
RESULTS
A total of 22 studies met the inclusion criteria for this study. There was a pooled rate of 27.5% (653/2373) deep UPC specimen positivity, and C acnes represented 76.4% (499/653) of these positive specimens. Inanimate specimen positivity was reported at a pooled rate of 20.1% (29/144) across 3 studies. Male patients were more likely to have a UPC; however, the significance of prior surgery, surgical approach, and type of surgery conflicted across multiple articles. Patient-reported outcomes and reoperation rates did not differ between positive-UPC and negative-UPC patients. The utilization of antibiotics and treatment regimen varied across studies; however, the reinfection rates following surgery did not statistically differ based on the inclusion of antibiotics.
CONCLUSION
UPCs are a frequent finding during shoulder surgery and C acnes represents the highest percentage of cultured bacteria. Various preoperative risk factors, surgical techniques, and postoperative treatment regimens did not significantly affect the incidence of UPCs as well as the clinical outcomes for UPC vs. non-UPC patients. A standardized protocol for treatment and follow-up would decrease physician uncertainty when faced with a UPC from shoulder surgery. Given the results of this review, shoulder surgeons can consider not drastically altering the postoperative clinical course in the setting of UPC with no other evidence of PJI.
Topics: Anti-Bacterial Agents; Arthritis, Infectious; Arthroplasty; Arthroplasty, Replacement, Shoulder; Bacteria; Humans; Male; Propionibacterium acnes; Prosthesis-Related Infections; Reoperation; Shoulder Joint
PubMed: 35513254
DOI: 10.1016/j.jse.2022.03.019 -
International Endodontic Journal Apr 2024Microorganisms colonizing the apical root canal system are conceivably the ones directly involved with the causation and maintenance of apical periodontitis. (Review)
Review
BACKGROUND
Microorganisms colonizing the apical root canal system are conceivably the ones directly involved with the causation and maintenance of apical periodontitis.
OBJECTIVES
This article systematically reviews the reports on the microbiome occurring exclusively at the apical root canal of teeth with primary and posttreatment apical periodontitis.
METHODS
The electronic databases PubMed, Embase, Web of Science, Science Direct, and Proquest were searched up to August 2023. Clinical studies using culture and molecular microbiology methods to identify the microbial taxa present exclusively in the apical root canal segment of infected teeth with apical periodontitis were included. Studies were critically assessed using the Joanna Briggs Institute Critical Prevalence Assessment Checklist.
RESULTS
From 2277 articles initially detected, 52 were selected for full reading and 21 were eventually included in this review. Of these, molecular methods were used in 19 and culture in 2 studies. Ten studies evaluated primary infections, 8 evaluated posttreatment infections, and 3 included both. Cryopulverization of the apical root specimens was conducted in 11 studies. All studies evaluated the prevalence and diversity of bacteria, and only one also reported on fungi. Overall, the most frequent/abundant bacterial taxa found in the apical canal of primary infections were Pseudoramibacter alactolyticus, Olsenella uli, Fusobacterium species, Streptococcus species, Porphyromonas endodontalis, Prevotella species, Actinomyces species, Parvimonas micra, Treponema denticola, Synergistetes species, and an as-yet uncharacterized taxon. In posttreatment infections, the most prevalent/abundant bacterial taxa included species of Streptococcus, Enterococcus, Fusobacterium, Actinomyces, Pseudoramibacter, Pseudomonas, and Propionibacterium. At the phylum level, Firmicutes was the most represented. The average apical bacterial load ranged from 10 to 10 in primary infections and from 10 to 10 in posttreatment infections.
DISCUSSION
Microbial diversity in the apical part of the root canal system was examined encompassing data from both primary and posttreatment infections. Heterogeneity amongst the studies, especially in sample collection and microbial identification methods, is an important limitation that prevented a meta-analysis.
CONCLUSIONS
There is a pronounced bacterial diversity in the infected apical canal, with a high interindividual variability. Different microbiome compositions at the species/genus level are observed according to the infection type.
REGISTRATION
PROSPERO CRD42021275886.
PubMed: 38634795
DOI: 10.1111/iej.14071 -
Vox Sanguinis Apr 2021Septic transfusion reactions are a principal cause of transfusion-related mortality. The frequency of detectable bacterial contamination is greater in platelets compared... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Septic transfusion reactions are a principal cause of transfusion-related mortality. The frequency of detectable bacterial contamination is greater in platelets compared to other blood components because platelets are stored at room temperature. Most strategies outlined in the September 2019 FDA guidance require both aerobic culture (AC) and anaerobic culture (AnC) testing. We performed a systematic review and meta-analysis in an effort to provide the best available estimate of the effectiveness of AnC.
MATERIALS AND METHODS
Our analysis was performed according to published guidelines. Broad and context-specific meta-analyses of bacterial detection rates in platelets by AnC were performed to assess the practical effectiveness of AnC as a risk control measure.
RESULTS
Seven studies with a total of 1 767 014 tested platelet components were included for analysis. With exclusion of positives due to Cutibacterium/Propionibacterium species and redundancy due to AC results, AnC detected 0·06 contamination events per thousand (EPT) components tested, twofold lower than the AC (0·12 EPT).
CONCLUSION
Excluding Cutibacterium/Propionibacterium species, AnC detects occasional bacterial contamination events that are not detected by AC (~1 in 17 000 platelet components).
Topics: Anaerobiosis; Bacteria; Bacteriological Techniques; Blood Platelets; Blood Safety; Drug Contamination; Humans; Platelet Transfusion; Transfusion Reaction
PubMed: 32996621
DOI: 10.1111/vox.13013 -
International Orthopaedics Apr 2017While as many as 50% of revision shoulder arthroplasties are culture positive, a consistent, clinically useful definition of a "periprosthetic shoulder infection" is... (Review)
Review
PURPOSE
While as many as 50% of revision shoulder arthroplasties are culture positive, a consistent, clinically useful definition of a "periprosthetic shoulder infection" is lacking. We conducted a systematic review of the published literature with respect to (1) the definition of a "periprosthetic shoulder infection", (2) the pre-operative evaluation for possible infection, and (3) the harvesting and culturing of specimens at the time of surgical revision.
METHODS
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified 20 studies concerning infection at the time of revision shoulder arthroplasty. The review was registered in the international Prospective Register of Systematic Reviews.
RESULTS
An explicit definition of infection was not present in six studies (27%). Classification systems used for periprosthetic hip and knee infections were used in three studies (14%). Clinical signs and symptoms were used in all definitions, but most studies did not report microbiologic results or culturing practices.
CONCLUSIONS
Synthesis of the literature on failed arthroplasties with positive cultures is compromised by lack of standardization, leaving surgeons without secure evidence on which to base diagnostic and treatment decisions. These decisions would be better informed if authors used a consistent approach in the evaluation of failed arthroplasties with respect to the number and source of specimens submitted, the culture technique, the number of specimens that became culture positive, the bacteria identified, and the bacterial load recovered from the shoulder.
LEVEL OF EVIDENCE
This was a systematic review of reports of all levels.
Topics: Arthroplasty, Replacement, Shoulder; Humans; Microbiological Techniques; Prosthesis-Related Infections; Reoperation; Shoulder Joint; Specimen Handling
PubMed: 28224190
DOI: 10.1007/s00264-017-3421-6 -
BMC Musculoskeletal Disorders May 2020One of the most common bacteria responsible for most Periprosthetic joint infection (PJI) is Propionibacterium acnes. Even though the rate of infections in patients...
BACKGROUND
One of the most common bacteria responsible for most Periprosthetic joint infection (PJI) is Propionibacterium acnes. Even though the rate of infections in patients undergoing total shoulder arthroplasty is increasing, effective diagnostic tests and the precautions taken during the surgery are not yet adequate. This systematic review aims to evaluate the effectiveness of antimicrobial prophylaxis in PJI in shoulder replacement and to provide health workers with the best approach to the use of antimicrobial agents based on currently available clinical evidence.
METHODS
a systematic review of the literature was carried out in accordance with the PRISMA Statement. Studies concerning the effectiveness of antimicrobial prophylaxis in the prevention of PJI in patients undergoing shoulder replacement were included.
RESULTS
Seven studies were included in the final analysis because they were considered valid. A total of 3272 patients underwent a surgical procedure, most of which were males. The male population has a greater presence of hair, therefore a greater risk of P. acnes. in surface cultures. Patients were assessed at an average follow-up period of 20 months ranging from 9 weeks to 53 months.
CONCLUSION
The optimal perioperative antimicrobial regimen is controversial. The clinical guidelines recommend the use of only one antibiotic as prophylaxis but considering the increase in the rates of antibiotic-resistant infections, the question arises whether antibiotic prophylaxis should be extended for adequate coverage. Shoulder arthroplasty performed on the male population must be carefully checked after surgery for the possible presence of P. Acnes.
Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Antibiotic Prophylaxis; Arthroplasty, Replacement, Shoulder; Child; Female; Follow-Up Studies; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Propionibacterium acnes; Prosthesis-Related Infections; Sex Factors; Shoulder Joint; Treatment Outcome; Young Adult
PubMed: 32393217
DOI: 10.1186/s12891-020-03332-z -
Journal Der Deutschen Dermatologischen... Oct 2006Inflammatory, medium to severe acne vulgaris is treated with systemic antibiotics worldwide. The rationale is an effect on Propionibacterium acnes as well as the... (Review)
Review
BACKGROUND
Inflammatory, medium to severe acne vulgaris is treated with systemic antibiotics worldwide. The rationale is an effect on Propionibacterium acnes as well as the intrinsic anti-inflammatory properties of these antibiotics. Although there are no correlations between the number of P. acnes and the severity of the disease, associations between the degree of humoral and cellular immune responses towards P. acnes and the severity of acne have been reported. Exact data on practical use of these compounds, such as differential efficacy or side effects are unavailable. A summary of currently available studies is presented.
METHODS
The data of studies of systemic antibiotic therapy of acne vulgaris up to 1975, the summary of literature in English up to 1999, a systematic review of minocycline from 2002 as well as the data of randomized controlled studies published and listed in Medline thereafter were reviewed.
RESULTS
Tetracyclines [tetracycline 1,000 mg daily, doxycycline 100 (-200) mg daily, minocycline 100 (-200) mg daily, lymecycline 300 (-600) mg] and erythromycin 1 000 mg daily are significantly more effective than placebo in the systemic treatment of inflammatory acne. The data for tetracycline are best founded. Clindamycin is similarly effective. Co-trimoxazole and trimethoprim are likely to be effective. Clear differences between the tetracyclines or between tetracycline and erythromycin cannot be ascertained. The data for the combination with topical treatments [topical benzoyl peroxide (BPO) or retinoids] suggest synergistic effects. Therefore systemic antibiotics should not be used as monotherapy. In case of similar efficacy, other criteria, such as pharmacokinetics (doxycycline, minocycline, lymecycline have longer half-lives than tetracyclines), the rate of side-effects (tetracycline: side effect-rate approximately 4 % mild side effects; erythromycin: frequent gastrointestinal complaints; minocycline: rare, but potentially severe hypersensitivity reactions; doxycycline: dose-dependent phototoxic reactions), the resistance rate [percentage of resistant bacteria higher with erythromycin (approximately 50 %) than with tetracycline-therapy (approximately 20 %)], and the costs of therapy have to be taken into account.
CONCLUSIONS
The systemic antibiotic therapy of widespread papulo-pustular acne not amenable to a topical therapy is effective and well-tolerated. In general therapy can be carried out for 3 months and should be combined with BPO to prevent resistance.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Dose-Response Relationship, Drug; Humans; Practice Guidelines as Topic; Practice Patterns, Physicians'
PubMed: 17010172
DOI: 10.1111/j.1610-0387.2006.06053.x