-
The Bone & Joint Journal Jul 2020Of growing concern in arthroplasty is the emergence of atypical infections, particularly (formerly ) sp. infections. Currently, the dermal colonization rate of about...
AIMS
Of growing concern in arthroplasty is the emergence of atypical infections, particularly (formerly ) sp. infections. Currently, the dermal colonization rate of about the hip is unknown. Therefore, the aim of this study was to investigate colonization rates of 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 .
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 sp. (65%), of which comprised the majority (n = 13; 87%). Other isolated microorganisms include coagulase-negative (n = 6), (n = 1), and (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 colonization about the hip, the majority anteriorly. Given the high colonization rate of , alternative skin preparations for total hip arthroplasty should be considered. Cite this article: 2020;102-B(7 Supple B):52-56.
Topics: Adult; Aged; Arthroplasty, Replacement, Hip; Biopsy; Clostridium; Corynebacterium; Female; Hip; Humans; Male; Middle Aged; Propionibacteriaceae; Skin; Staphylococcus; Thigh
PubMed: 32600208
DOI: 10.1302/0301-620X.102B7.BJJ-2019-1606.R1 -
Anaerobe Apr 2020FMX101 4% minocycline foam (FMX101 4%) is a novel, topical minocycline formulation for treatment of acne vulgaris. We report that FMX101 4% had an MIC of 0.25 μg/ml...
FMX101 4% minocycline foam (FMX101 4%) is a novel, topical minocycline formulation for treatment of acne vulgaris. We report that FMX101 4% had an MIC of 0.25 μg/ml and was ≥4-fold more active than comparator antimicrobials against a panel of 98 clinical Cutibacterium acnes isolates. The panel was diverse by clonal complex and sequence type, having 20 novel multi-locus sequence types including clonal complexes and sequence types associated with acne (CC1, CC3, and CC4; ST1 and ST3). Some isolates were phenotypically resistant to clindamycin (6.1%), erythromycin (14.3%), and tetracycline (2.0% intermediate resistance). Six isolates (6.4%) carried a mutation in the quinolone resistance-determining region of gyrA. With C. acnes, spontaneous resistance to FMX101 4% occurred at frequencies ranging from ≤5 × 10 to <1 × 10; mutations were identified in rpsJ, a gene encoding 30S ribosomal protein S10. No mutant exhibited a minocycline MIC above 0.5 μg/ml. No second-step mutation in previously isolated mutants or strains containing rpsJ ± 16S rRNA mutations was detected following minocycline challenge. Minocycline retained antibacterial activity against C. acnes over 15 multiple passages; thus, no selective growth advantage for minocycline-resistant mutants occurred under the experimental conditions. FMX101 4% has the potential to retain the favorable resistance profile of minocycline in diverse C. acnes isolates while providing the benefits of a topical formulation for treatment of acne vulgaris.
Topics: Anti-Bacterial Agents; Drug Resistance, Bacterial; Genotype; Gram-Positive Bacterial Infections; Humans; Microbial Sensitivity Tests; Minocycline; Multilocus Sequence Typing; Mutation; Propionibacterium acnes
PubMed: 32058277
DOI: 10.1016/j.anaerobe.2020.102169 -
International Journal of Antimicrobial... Oct 2020This study evaluated the clinical, laboratory, microbiological, radiological and treatment characteristics of patients with early-onset and late-onset spinal...
This study evaluated the clinical, laboratory, microbiological, radiological and treatment characteristics of patients with early-onset and late-onset spinal implant-associated infections. Patients diagnosed with spinal implant-associated infection between 2015-2019 were prospectively included and treated according to a standardised algorithm. Infections were classified as early-onset (≤6 weeks) and late-onset (>6 weeks). Among 250 patients, 152 (61%) had early-onset and 98 (39%) had late-onset infection. Local inflammatory signs was the most common manifestation in early-onset infections (84%), whereas late-onset infections presented mainly with persisting or increasing local pain (71%). Sonication fluid was more often positive than peri-implant tissue samples (90% vs. 79%; P = 0.016), particularly in late-onset infections (92% vs. 75%; P = 0.005). Predominant pathogens were coagulase-negative staphylococci, Staphylococcus aureus and Cutibacterium spp. Debridement and implant retention was the most common surgical approach in early-onset infections (85%), whereas partial or complete implant exchange was mainly performed in late-onset infections (62%). Of the 250 patients, 220 (88%) received biofilm-active antibiotics, and median treatment duration was 11.7 weeks. Moreover, 49 patients (20%) needed more than one revision for infection and six patients (2.4%) died during hospital stay. Concluding, most spinal implant-associated infections were acquired during surgery and presented within 6 weeks of surgery. Infections presented mainly with local inflammatory signs in early-onset and with persisting or increasing pain in late-onset infections. Sonication was the most sensitive microbiological method, particularly in late-onset infections. Debridement and implant retention was used in well-integrated implants without loosening, independent of the time of infection onset.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Biofilms; Child; Cohort Studies; Doxycycline; Female; Fusidic Acid; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Propionibacteriaceae; Prospective Studies; Prosthesis-Related Infections; Quinolones; Rifampin; Spine; Staphylococcus aureus; Trimethoprim, Sulfamethoxazole Drug Combination; Young Adult
PubMed: 32726675
DOI: 10.1016/j.ijantimicag.2020.106116 -
Journal of Shoulder and Elbow Surgery Aug 2020Shoulder periprosthetic infections are predominantly caused by bacteria residing in the skin of healthy individuals. Knowledge of the factors associated with the loads...
BACKGROUND
Shoulder periprosthetic infections are predominantly caused by bacteria residing in the skin of healthy individuals. Knowledge of the factors associated with the loads of the different cutaneous bacteria in individuals having shoulder arthroplasty may help identify patients at higher risk of periprosthetic infection and help guide preventive measures. For this reason, we tested the hypothesis that easy-to-obtain preoperative characteristics were significantly associated with the cutaneous microbiology and the loads of specific bacteria in shoulders having joint replacement.
METHODS
This study identified the microbiology of the unprepared epidermal skin surface and of the dermal edge freshly incised at surgery in 332 patients having primary shoulder arthroplasty. The load of bacteria in each sample was characterized as a value based on the laboratory report: 0 for "no growth"; 0.1 for "one colony only" or for "broth only"; and 1, 2, 3, and 4 for 1+, 2+, 3+, and 4+ growth, respectively. The relationships between preoperative patient characteristics and these semiquantitative results of the cutaneous cultures were analyzed.
RESULTS
Cultures of the unprepared epidermal skin surface showed positive results for a wide variety of organisms, including Cutibacterium in 72%, coagulase-negative Staphylococcus in 61%, and a spectrum of other organisms in 32%. By contrast, cultures of the freshly incised dermal edge showed a great preponderance of Cutibacterium (34%) in comparison to low levels of coagulase-negative Staphylococcus (8%) and other organisms (2%). An increased dermal load of Cutibacterium was significantly associated with male sex, younger patient age, American Society of Anesthesiologists class 1, use of testosterone supplements, prior shoulder surgery, and higher Cutibacterium loads on the unprepared skin surface.
CONCLUSIONS
Although the microbiology of the unprepared skin surface is diverse, the same is not true for the freshly incised dermis, where Cutibacterium is the predominant organism. Readily available preoperative patient characteristics are significantly associated with the load of Cutibacterium in the incised dermis. Preoperative cultures of the unprepared skin surface appear to be a new method for predicting the type and load of bacteria found in the freshly incised dermis at the time of surgery. Additional studies are needed to determine whether preoperative cultures of the unprepared epidermal skin surface can provide a method for identifying patients at increased risk of shoulder periprosthetic infections.
Topics: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Shoulder; Epidermis; Female; Humans; Male; Middle Aged; Propionibacteriaceae; Prosthesis-Related Infections; Retrospective Studies; Risk Factors; Staphylococcus; Young Adult
PubMed: 32247723
DOI: 10.1016/j.jse.2019.12.031 -
Medecine Et Maladies Infectieuses May 2020Cutibacterium acnes is a commensal bacterium of the skin, frequently reported in prosthetic shoulder or spinal implant infections, but rarely in cranial and intracranial...
INTRODUCTION
Cutibacterium acnes is a commensal bacterium of the skin, frequently reported in prosthetic shoulder or spinal implant infections, but rarely in cranial and intracranial infections.
METHODS
We retrospectively reviewed patients with intracranial samples positive to Cutibacterium acnes managed in the neurosurgical units of our hospital of Lyon, France, between 2008-2016.
RESULTS
We included 29 patients, of whom 23 had empyema (with or without abscess), 17 had cranial osteomyelitis, and six only had abscess. Prior neurosurgery was reported in 28 patients, and the remaining patient had four spontaneous abscesses. Twelve patients had polymicrobial infections, including methicillin-susceptible Staphylococcus in 11 cases. The clinical diagnosis was difficult because of indolent and delayed symptoms: a CT scan or MRI was required. Thirteen patients (52%) had material at the infection site. All patients with bone flap implant or bones from biological banks had a bone flap-associated infection. Drainage was surgically performed in 25 cases or by CT scan-guided aspiration in four cases. All patients received an adapted antibiotic therapy (from three weeks to six months). The outcome was favorable in 28 patients. Three patients relapsed during the antibiotic therapy, requiring further surgery.
CONCLUSION
Cutibacterium acnes can be responsible for postoperative empyema and cerebral abscesses, with particular indolent forms, which make their diagnosis difficult. They are often polymicrobial and associated with bone flap osteomyelitis. Their outcome is favorable after drainage and adapted antibiotic therapy.
Topics: Adult; Aged; Anti-Bacterial Agents; Brain Abscess; Coinfection; Combined Modality Therapy; Craniotomy; Delayed Diagnosis; Drainage; Drug Resistance, Microbial; Empyema; Female; Follow-Up Studies; Gram-Positive Bacterial Infections; Humans; Male; Middle Aged; Neuroimaging; Osteomyelitis; Propionibacteriaceae; Retrospective Studies; Skin; Skull; Surgical Flaps; Surgical Wound Infection; Virulence
PubMed: 31668987
DOI: 10.1016/j.medmal.2019.09.015 -
The Journal of Investigative Dermatology Jan 2022Previous cross-sectional studies have shown that skin microbiomes in adults are distinct from those in children. However, the human skin microbiome in individuals as...
Previous cross-sectional studies have shown that skin microbiomes in adults are distinct from those in children. However, the human skin microbiome in individuals as they sexually mature has not been studied as extensively. We performed a prospective, longitudinal study to investigate the puberty-associated shifts in skin microbiota. A total of 12 healthy children were evaluated every 6-18 months for up to 6 years. Using 16S ribosomal RNA (V1-V3) and internal transcribed spacer 1 amplicon sequencing analyzed with Divisive Amplicon Denoising Algorithm 2, we characterized the bacterial and fungal communities of five different skin and nares sites. We identified significant alterations in the composition of skin microbial communities, transitioning toward a more adult microbiome, during puberty. The microbial shifts were associated with Tanner stages (classification method for the degree of sexual maturation) and showed noticeable sex-specific differences. Over time, female children demonstrated a predominance of Cutibacterium with decreasing diversity. Among fungi, Malassezia predominated at most skin sites in more sexually mature subjects, which was more pronounced in female children. The higher relative abundances of these lipophilic taxa-C. acnes and M. restricta-were strongly associated with serum sex hormone concentrations with known influence on sebaceous gland activity. Taken together, our results support the relationship between sexual maturation, skin physiology, and the skin microbiome.
Topics: Adult; Child; Child, Preschool; Female; Gonadal Steroid Hormones; Humans; Infant; Malassezia; Male; Microbiota; Propionibacteriaceae; Prospective Studies; Puberty; RNA, Ribosomal, 16S; Sebaceous Glands; Sex Characteristics; Skin
PubMed: 34252398
DOI: 10.1016/j.jid.2021.04.034 -
Microbiology Spectrum Feb 2022The Gram-positive anaerobic bacterium Cutibacterium acnes is a major inhabitant of human skin and has been implicated in acne vulgaris formation and in the formation of...
The Gram-positive anaerobic bacterium Cutibacterium acnes is a major inhabitant of human skin and has been implicated in acne vulgaris formation and in the formation of multispecies biofilms with other skin-inhabiting organisms like Staphylococcus aureus and Candida albicans. Indoles are widespread in nature (even in human skin) and function as important signaling molecules in diverse prokaryotes and eukaryotes. In the present study, we investigated the antibacterial and antibiofilm activities of 20 indoles against . Of the indoles tested, indole-3-carbinol at 0.1 mM significantly inhibited biofilm formation by without affecting planktonic cell growth, and the anticancer drug 3,3'-diindolylmethane (DIM) at 0.1 mM (32 μg/mL) also significantly inhibited planktonic cell growth and biofilm formation by , whereas the other indoles and indole itself were less effective. Also, DIM at 0.1 mM successfully inhibited multispecies biofilm formation by , S. aureus, and C. albicans. Transcriptional analyses showed that DIM inhibited the expressions of several biofilm-related genes in , and at 0.05 mM, DIM inhibited hyphal formation and cell aggregation by C. albicans. These results suggest that DIM and other indoles inhibit biofilm formation by and have potential use for treating associated diseases. Since indoles are widespread in nature (even in human skin), we hypothesized that indole and its derivatives might control biofilm formation of acne-causing bacteria (Cutibacterium acnes and Staphylococcus aureus) and fungal Candida albicans. The present study reports for the first time the antibiofilm and antimicrobial activities of several indoles on . Of the indoles tested, two anticancer agents, indole-3-carbinol and 3,3'-diindolylmethane found in cruciferous vegetables, significantly inhibited biofilm formation by . Furthermore, the most active 3,3'-diindolylmethane successfully inhibited multispecies biofilm formation by , S. aureus, and C. albicans. Transcriptional analyses showed that 3,3'-diindolylmethane inhibited the expressions of several biofilm-related genes including lipase, hyaluronate lyase, and virulence-related genes in , and 3,3'-diindolylmethane inhibited hyphal formation and cell aggregation by C. albicans. Our findings show that 3,3'-diindolylmethane offers a potential means of controlling acne vulgaris and multispecies biofilm-associated infections due to its antibiofilm and antibiotic properties.
Topics: Acne Vulgaris; Anti-Bacterial Agents; Antineoplastic Agents; Bacteria; Biofilms; Candida albicans; Humans; Indoles; Microbial Sensitivity Tests; Phylogeny; Propionibacteriaceae; Staphylococcus aureus; Virulence
PubMed: 35107361
DOI: 10.1128/spectrum.02056-21 -
Journal of Drugs in Dermatology : JDD Jun 2007The genome of Propionibacterium acnes, the microbe presumed to be at least partially etiologic for the development of acne, has recently been decoded. The genome... (Review)
Review
The genome of Propionibacterium acnes, the microbe presumed to be at least partially etiologic for the development of acne, has recently been decoded. The genome supports long-standing concepts regarding acne pathogenesis, but also demonstrates heretofore unknown and/or unsuspected bacterial properties, which might play a role in disease occurrence. In turn, understanding the genome may lead to new therapeutic avenues, as summarized in this manuscript.
Topics: Acne Vulgaris; Genome, Bacterial; Humans; Propionibacterium acnes; Sequence Analysis, DNA
PubMed: 17668523
DOI: No ID Found -
International Journal of Systematic and... Feb 2018A Gram-stain-positive, non-motile, yellow and rod-shaped actinobacterium, designated strain Brt-A, isolated from oil-contaminated soil, grew at 15-40 °C, at pH...
A Gram-stain-positive, non-motile, yellow and rod-shaped actinobacterium, designated strain Brt-A, isolated from oil-contaminated soil, grew at 15-40 °C, at pH 5.5-10.0 and at 0-2 % (w/v) NaCl concentration. This strain was characterized by a polyphasic approach. The 16S rRNA gene sequence analysis showed that strain Brt-A belonged to the genus Tessaracoccus and is closely related to Tessaracoccus rhinocerotis YIM 101269, Tessaracoccus flavescens SST-39, Tessaracoccus defluvii LNB-140 and Tessaracoccus flavus RP1 (99.03, 97.00, 96.88, and 96.46 % gene sequence similarity, respectively). The predominant respiratory quinone was MK-9(H4); the major polar lipids were phosphatidylglycerol and diphosphatidylglycerol; the predominant polyamines were spermine and spermidine; and the major fatty acids were anteiso-C15 : 0 and iso-C15 : 0. The cell-wall peptidoglycan contained ll-diaminopimelic acid; and glucose and ribose were detected as diagnostic sugars from whole-cell hydrolysates. The DNA G+C content was 68.1 mol%. The DNA-DNA relatedness between strain Brt-A and its closely related species of the genus Tessaracoccus were between 55.0-44.0 %, which fall below the threshold value of 70 % for the strain to be considered as novel. The morphological, physiological, chemotaxonomic and phylogenetic analyses clearly distinguished this strain from its closest phylogenetic neighbours. Thus, strain Brt-A represents a novel species of the genus Tessaracoccus, for which the name Tessaracoccus terricola sp. nov. is proposed. The type strain is Brt-A (=KEMB 9005-690=KACC 19391=JCM 32157).
Topics: Bacterial Typing Techniques; Base Composition; DNA, Bacterial; Diaminopimelic Acid; Fatty Acids; Nepal; Nucleic Acid Hybridization; Petroleum Pollution; Phospholipids; Phylogeny; Pigmentation; Propionibacteriaceae; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Soil Microbiology; Spermidine; Spermine; Vitamin K 2
PubMed: 29297849
DOI: 10.1099/ijsem.0.002537 -
Microbiome Feb 2021The human skin microbiota is considered to be essential for skin homeostasis and barrier function. Comprehensive analyses of its function would substantially benefit...
BACKGROUND
The human skin microbiota is considered to be essential for skin homeostasis and barrier function. Comprehensive analyses of its function would substantially benefit from a catalog of reference genes derived from metagenomic sequencing. The existing catalog for the human skin microbiome is based on samples from limited individuals from a single cohort on reference genomes, which limits the coverage of global skin microbiome diversity.
RESULTS
In the present study, we have used shotgun metagenomics to newly sequence 822 skin samples from Han Chinese, which were subsequently combined with 538 previously sequenced North American samples to construct an integrated Human Skin Microbial Gene Catalog (iHSMGC). The iHSMGC comprised 10,930,638 genes with the detection of 4,879,024 new genes. Characterization of the human skin resistome based on iHSMGC confirmed that skin commensals, such as Staphylococcus spp, are an important reservoir of antibiotic resistance genes (ARGs). Further analyses of skin microbial ARGs detected microbe-specific and skin site-specific ARG signatures. Of note, the abundance of ARGs was significantly higher in Chinese than Americans, while multidrug-resistant bacteria ("superbugs") existed on the skin of both Americans and Chinese. A detailed analysis of microbial signatures identified Moraxella osloensis as a species specific for Chinese skin. Importantly, Moraxella osloensis proved to be a signature species for one of two robust patterns of microbial networks present on Chinese skin, with Cutibacterium acnes indicating the second one. Each of such "cutotypes" was associated with distinct patterns of data-driven marker genes, functional modules, and host skin properties. The two cutotypes markedly differed in functional modules related to their metabolic characteristics, indicating that host-dependent trophic chains might underlie their development.
CONCLUSIONS
The development of the iHSMGC will facilitate further studies on the human skin microbiome. In the present study, it was used to further characterize the human skin resistome. It also allowed to discover the existence of two cutotypes on the human skin. The latter finding will contribute to a better understanding of the interpersonal complexity of the skin microbiome. Video abstract.
Topics: Adult; Aged; Anti-Bacterial Agents; China; Drug Resistance, Microbial; Ethnicity; Female; Genes, Bacterial; Humans; Male; Metagenomics; Microbiota; Middle Aged; Moraxella; North America; Propionibacteriaceae; Skin; Staphylococcus; Symbiosis; Young Adult
PubMed: 33597039
DOI: 10.1186/s40168-020-00995-7