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Duffy HR, Ashton NN, Stulce P, Blair A, Farnsworth R, Ormiston L, Kwok AC, Williams DL. Skin-Dwelling Bacteria Survive Preoperative Skin Preparation in Reconstruction Surgery. J Clin Med 2025; 14:3417. [PMID: 40429412 PMCID: PMC12111911 DOI: 10.3390/jcm14103417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Revised: 05/07/2025] [Accepted: 05/09/2025] [Indexed: 05/29/2025] Open
Abstract
Background/Objectives: Accurately determining the bacterial bioburden that survives preoperative skin preparation (PSP) is critical in understanding PSP efficacy and its limitations. Clinical PSP approval relies on a bacterial sampling method described in the American Society for Testing and Materials (ASTM) standard E1173-15. Though common, this technique may overlook deep-dwelling skin bacteria. The objective of this study was to test the hypothesis that deep-dwelling skin flora would survive PSP, and more growth would be detected using a destructive sampling method compared with ASTM E1173-15. Methods: Twelve female participants with a scheduled deep inferior epigastric perforator (DIEP) artery flap procedure at the Huntsman Cancer Institute in Salt Lake City, UT, were enrolled between January and August 2024. PSP was performed using three 26 mL ChloraPrep applicators (2% CHG), and excess tissue was collected. Bacteria in the skin were quantified using a destructive sampling method and ASTM E1173-15, and bioburden outcomes were compared. Two participants were excluded from the quantitative analysis. Results: Bacteria survived PSP in every participant. A greater diversity and more bacteria were quantified with destructive sampling than ASTM E1173-15 (p < 0.01). Generally, anaerobic bioburden values were higher than aerobic bioburden values. Higher bioburden correlated with processing more skin from a participant. Genotypic identification of select isolates identified Staphylococcus epidermidis and Cutibacterium acnes (formerly known as Propionibacterium acnes) as surviving bacteria, among others. Immunofluorescence revealed bacteria in all skin layers. No participant exhibited clinical signs of infection in the abdominal region. Human data corroborated previous porcine data collected using destructive skin sampling after PSP. Conclusions: Clinical PSP application does not create a sterile field. Destructive skin sampling techniques may be more effective than ASTM E1173-15 at resolving bacterial PSP survivors contributing to SSI risk.
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Affiliation(s)
- Hannah R. Duffy
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (P.S.); (A.B.); (R.F.)
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Nicholas N. Ashton
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (P.S.); (A.B.); (R.F.)
| | - Porter Stulce
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (P.S.); (A.B.); (R.F.)
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Abbey Blair
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (P.S.); (A.B.); (R.F.)
| | - Ryan Farnsworth
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (P.S.); (A.B.); (R.F.)
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Laurel Ormiston
- Department of Surgery, Division of Plastic Surgery, University of Utah Health, Salt Lake City, UT 84112, USA (A.C.K.)
| | - Alvin C. Kwok
- Department of Surgery, Division of Plastic Surgery, University of Utah Health, Salt Lake City, UT 84112, USA (A.C.K.)
| | - Dustin L. Williams
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (P.S.); (A.B.); (R.F.)
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Şahin R, Luo TD, Campofreda G, Kıvrak M, Gehrke T, Citak M. Cutibacterium infections after total hip arthroplasty: does surgical approach play a role? INTERNATIONAL ORTHOPAEDICS 2025; 49:1101-1106. [PMID: 40119900 DOI: 10.1007/s00264-025-06500-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2025] [Accepted: 03/10/2025] [Indexed: 03/25/2025]
Abstract
PURPOSE Cutibacterium species, formerly known as Propionibacterium, are gram-positive, anaerobic bacilli increasingly recognized as a cause of periprosthetic joint infection (PJI) following total hip arthroplasty (THA). This study aimed to compare the incidence of Cutibacterium-associated PJI among different surgical approaches for THA. METHODS A retrospective review was conducted on patients treated for Cutibacterium-associated PJI following THA between 2011 and 2021. Patients were categorized based on the surgical approach: direct anterior (DAA), lateral, or posterior. A total of 211 patients met inclusion criteria, comprising 153 men (72.5%) and 58 women (27.5%). RESULTS Among the 211 cases of Cutibacterium-associated PJI, 102 (48.3%) underwent THA via DAA, 63 (29.9%) via a lateral approach, and 46 (21.8%) via a posterior approach. There were no significant differences between groups in age, sex, laterality, BMI or fistula formation. The incidence of Cutibacterium PJI was significantly higher with DAA compared to the lateral (P < 0.001) and posterior approaches (P < 0.001), while no significant difference was observed between lateral and posterior approaches (P = 0.059). The rate of Cutibacterium-associated PJI has increased since 2016. CONCLUSION Nearly half of all Cutibacterium PJIs were associated with the DAA. Surgeons should be aware of this increased risk and implement appropriate preventive measures when performing THA via DAA.
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Affiliation(s)
- Rıfat Şahin
- Recep Tayyip Erdoğan University, Rize, Turkey.
- Helios Endo-Klinik Hamburg, Hamburg, Germany.
| | - T David Luo
- Helios Endo-Klinik Hamburg, Hamburg, Germany
- Indiana Joint Replacement Institute, Fort Wayne, Indiana, USA
| | - Gianluca Campofreda
- Helios Endo-Klinik Hamburg, Hamburg, Germany
- IRCCS Humanitas Research Hospital, Rozzano, Italy
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Álvarez-Muñoz M, Jerez-Olate C, Opazo-Capurro A, Alcántara-Dufeu R, Bello-Toledo H, González-Rocha G, Sánchez-Sanhueza G. Whole-genome sequencing analysis of Cutibacterium spp. recovered from health care-associated endodontic infections. Arch Oral Biol 2025; 173:106207. [PMID: 40010066 DOI: 10.1016/j.archoralbio.2025.106207] [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: 05/26/2024] [Revised: 01/23/2025] [Accepted: 02/18/2025] [Indexed: 02/28/2025]
Abstract
OBJECTIVE Cutibacterium acnes (C. acnes) has been detected in culture and molecular studies of endodontic microbiota, indicating its potential as a neglected pathogen in endodontic infections. This study aimed to conduct a complete genomic analysis of three Cutibacterium spp. isolates obtained from persistent endodontic infections in patients from Chile. DESIGN Whole genome sequencing and comprehensive genomic analysis using diverse bioinformatics platforms and databases were carried out. RESULTS In-silico analysis confirmed that strains A1 and E3 correspond to C. acnes species, while strain B1 corresponds to C. namnetense. Additionally, C. acnes strain A1 belongs to the phylotype IA1, sequence type (ST) 4 and belongs to the clonal complex (CC) 4, whereas C. acnes strain E3 belongs to a novel ST. No antibiotic resistance, however, a variable distribution and identity of the VF was found. CONCLUSIONS Detailed analysis of genes associated with virulence factors shed light on the intrinsic pathogenic capacity of these strains, which may indicate differential adaptation to their specific niches or diversity in pathogenicity within the species.
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Affiliation(s)
- Mónica Álvarez-Muñoz
- Departamento de Odontología Restauradora, Facultad de Odontología, Universidad de Concepción, Chile
| | - Christian Jerez-Olate
- Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Lientur 1457, Concepción, Chile; Laboratorio de Investigación en Agentes Antibacterianos (LIAA), Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Andrés Opazo-Capurro
- Laboratorio de Investigación en Agentes Antibacterianos (LIAA), Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile; Grupo de Estudio en Resistencia Antimicrobiana (GRAM), Universidad de Concepción, Chile
| | - Raúl Alcántara-Dufeu
- Departamento de Odontología Restauradora, Facultad de Odontología, Universidad de Concepción, Chile
| | - Helia Bello-Toledo
- Laboratorio de Investigación en Agentes Antibacterianos (LIAA), Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Gerardo González-Rocha
- Laboratorio de Investigación en Agentes Antibacterianos (LIAA), Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile; Grupo de Estudio en Resistencia Antimicrobiana (GRAM), Universidad de Concepción, Chile
| | - Gabriela Sánchez-Sanhueza
- Departamento de Odontología Restauradora, Facultad de Odontología, Universidad de Concepción, Chile; Laboratorio de Investigación en Agentes Antibacterianos (LIAA), Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile.
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Wizenty J, Sigal M. Helicobacter pylori, microbiota and gastric cancer - principles of microorganism-driven carcinogenesis. Nat Rev Gastroenterol Hepatol 2025; 22:296-313. [PMID: 40011753 DOI: 10.1038/s41575-025-01042-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2025] [Indexed: 02/28/2025]
Abstract
The demonstration that Helicobacter pylori is a pathogenic bacterium with marked carcinogenic potential has paved the way for new preventive approaches for gastric cancer. Although decades of research have uncovered complex interactions of H. pylori with epithelial cells, current insights have refined our view on H. pylori-associated carcinogenesis. Specifically, the cell-type-specific effects on gastric stem and progenitor cells deep in gastric glands provide a new view on the ability of the bacteria to colonize long-term, manipulate host responses and promote gastric pathology. Furthermore, new, large-scale epidemiological data have shed light on factors that determine why only a subset of carriers progress to gastric cancer. Currently, technological advances have brought yet another revelation: H. pylori is far from the only microorganism able to colonize the stomach. Instead, the stomach is colonized by a diverse gastric microbiota, and there is emerging evidence for the occurrence and pathological effect of dysbiosis resulting from an aberrant interplay between H. pylori and the gastric mucosa. With the weight of this evidence mounting, here we consider how the lessons learned from H. pylori research inform and synergize with this emerging field to bring a more comprehensive understanding of the role of microbes in gastric carcinogenesis.
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Affiliation(s)
- Jonas Wizenty
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, BIH Biomedical Innovation Academy and BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Michael Sigal
- Department of Hepatology and Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany.
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Kaplan JB, Muzaleva A, Sailer M, Huizinga RB, Kridin K. Synergistic activity of dispersin B and benzoyl peroxide against Cutibacterium acnes/Staphylococcus epidermidis dual-species biofilms. PLoS One 2025; 20:e0320662. [PMID: 40146741 PMCID: PMC11949332 DOI: 10.1371/journal.pone.0320662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Accepted: 02/23/2025] [Indexed: 03/29/2025] Open
Abstract
Cutibacterium acnes plays a key role in the development of acne vulgaris, with biofilm formation contributing to its persistence and resistance to antimicrobial treatments. A critical component of C. acnes biofilms is poly-N-acetylglucosamine (PNAG), an exopolysaccharide that facilitates both biofilm stability and biocide resistance. This study evaluated the efficacy of the PNAG-degrading enzyme dispersin B in enhancing the susceptibility of C. acnes biofilms to benzoyl peroxide (BP), a common anti-acne agent. Dual-species biofilms of C. acnes and Staphylococcus epidermidis, which has been shown to promote C. acnes biofilm growth under aerobic conditions, were cultivated in glass tubes and treated with dispersin B (5-80 µg/mL), BP (0.1-2.5%), or a combination of both. Dispersin B or BP alone reduced C. acnes colony-forming units (CFUs) by 1-2 log units. However, sequential treatment with dispersin B followed by BP achieved a synergistic effect, yielding a >6-log reduction in CFUs. Remarkably, concentrations as low as 5 µg/mL dispersin B combined with 0.5% BP efficiently eradicated C. acnes from the dual-species biofilms. These findings highlight the protective role of PNAG against BP and demonstrate the potential of dispersin B as an adjunctive therapy to enhance the efficacy of BP in acne treatment.
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Affiliation(s)
- Jeffrey B. Kaplan
- Department of Biology, American University, Washington, District of Columbia, United States of America
- Laboratory for Skin Research, Institute for Medical Research, Galilee Medical Center, Nahariya, Israel
| | | | | | | | - Khalaf Kridin
- Laboratory for Skin Research, Institute for Medical Research, Galilee Medical Center, Nahariya, Israel
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Thoraval L, Varin-Simon J, Ohl X, Velard F, Reffuveille F, Tang-Fichaux M. Cutibacterium acnes and its complex host interaction in prosthetic joint infection: Current insights and future directions. Res Microbiol 2025; 176:104265. [PMID: 39701197 DOI: 10.1016/j.resmic.2024.104265] [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: 06/28/2024] [Revised: 11/26/2024] [Accepted: 12/17/2024] [Indexed: 12/21/2024]
Abstract
Cutibacterium acnes is a commensal Gram-positive anaerobic bacterium that can also act as an opportunistic pathogen in various diseases, particularly in prosthetic joint infections (PJI). Throughout this review, we delve into the current understanding of the intricate interactions between C. acnes and host cells and discuss bacterial persistence in the host. C. acnes colonization and subsequent PJI set-up represent complex processes involving bacterial adhesion, immune recognition, and host response mechanisms. We highlight existing knowledge and gaps in specific host-pathogen interactions and stress the importance of acquiring additional information to develop targeted strategies for preventing and treating C. acnes-related PIJ.
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Affiliation(s)
- Léa Thoraval
- Université de Reims Champagne-Ardenne, BIOS, Reims, France
| | | | - Xavier Ohl
- Université de Reims Champagne-Ardenne, CHU Reims, BIOS, Service D'Orthopédie et Traumatologie, Reims, France
| | | | - Fany Reffuveille
- Université de Reims Champagne-Ardenne, BIOS, UFR Pharmacie, Reims, France.
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Alazmi EA, Alqarni GS, Musslem MT, Samargandi R. Spontaneous Clavicular Osteomyelitis Caused by Cutibacterium acnes Treated with Calcium Sulfate Beads. J Orthop Case Rep 2025; 15:27-32. [PMID: 40092233 PMCID: PMC11907152 DOI: 10.13107/jocr.2025.v15.i03.5322] [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: 12/11/2024] [Revised: 01/24/2025] [Indexed: 03/19/2025] Open
Abstract
Introduction Osteomyelitis due to Cutibacterium acnes in the clavicle without a history of previous surgery is extremely rare and has been reported in one previous study. In this report, we delve into a case of clavicular osteomyelitis caused by C. acnes without the presence of hardware materials. Case Report We report here a case of a 32-year-old female presented with spontaneous clavicular osteomyelitis due to C. acnes that failed with medical management. The Patient was successfully treated by surgical debridement and calcium sulfate filling that impregnated with local antibiotics. Conclusion This case demonstrates that clavicular osteomyelitis can be caused by C. acnes even without the presence of a device. Therefore, cultures from potential bone infections that yield C. acnes should not be dismissed as contaminants. Combining clinical and laboratory criteria with emerging microbiologic tests may enhance the predictive value of C. acnes diagnostic testing in the future.
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Affiliation(s)
- Essa A Alazmi
- College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | | | | | - Ramy Samargandi
- Department of Orthopedic Surgery, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Walker Z, Shuster D, Sosnoski D, Hamade A, Milia M, Saad H. Subclinical Presentation of Cutibacterium acnes Infection Following Revision Rotator Cuff Surgery. Cureus 2025; 17:e80080. [PMID: 40190936 PMCID: PMC11970337 DOI: 10.7759/cureus.80080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2025] [Indexed: 04/09/2025] Open
Abstract
We present a unique case of an individual who presented with a culture-proven Cutibacterium acnes (C. acnes) infection 2.5 months after a revision arthroscopic rotator cuff repair. Instead of waiting for the result of aspiration cultures and consequently delaying surgery, we decided to take the patient to the operating room for arthroscopic irrigation and debridement on the date of presentation. Our purpose is to add to the existing evidence of C. acnes septic arthritis and, more specifically, to highlight the subclinical nature of this infection and our prompt decision to take the patient to the operating room for irrigation and debridement without culture-proven infection.
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Affiliation(s)
- Zachary Walker
- Orthopedic Surgery, Corewell Health Farmington Hills, Farmington Hills, USA
- Orthopedic Surgery, Corewell Health Dearborn, Dearborn, USA
| | - David Shuster
- Orthopedic Surgery, Corewell Health Farmington Hills, Farmington Hills, USA
- Orthopedic Surgery, Corewell Health Dearborn, Dearborn, USA
| | - David Sosnoski
- Orthopedic Surgery, Corewell Health Farmington Hills, Farmington Hills, USA
- Orthopedic Surgery, Corewell Health Dearborn, Dearborn, USA
| | - Ali Hamade
- Orthopedic Surgery, Corewell Health Farmington Hills, Farmington Hills, USA
- Orthopedic Surgery, Corewell Health Dearborn, Dearborn, USA
| | - Marc Milia
- Orthopedic Surgery, Corewell Health Dearborn, Dearborn, USA
| | - Hussein Saad
- Orthopedic Surgery, Corewell Health Dearborn, Dearborn, USA
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Burden E, Seyoum Y, Evans JP, Thomas W, Kitson J, Batten T, Patel R, van der Giezen M, Smith C. Mapping the microbial landscape and variations based on biological sex, age, and biopsy location in the shoulder skin microbiome. J Shoulder Elbow Surg 2025:S1058-2746(25)00188-0. [PMID: 40032061 DOI: 10.1016/j.jse.2025.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2024] [Revised: 01/19/2025] [Accepted: 01/23/2025] [Indexed: 03/05/2025]
Abstract
BACKGROUND The organisms responsible for periprosthetic joint infections (PJIs) of the shoulder are often skin pathogens originating from the patient's own skin flora at the time of surgery. Understanding the normal skin flora around the shoulder is an important step to identify the range of organisms that could be responsible for PJI and to ensure optimization of culture mediums to identify them. This study aimed to provide the first description of the shoulder skin microbiome using high-throughput next-generation sequencing methodology and explore variations by age, biological sex, and biopsy location. METHODS Patients undergoing arthroscopic surgery were approached for informed consent to have punch biopsies taken from anterior, lateral, and posterior arthroscopy portal sites. DNA extraction was undertaken followed by illumina sequencing, focusing on the V3-V4 regions of the 16S rRNA gene. Amplicon sequence variants (ASVs) were generated using Deblur workflow and used for taxonomic assignment. Variation in the microbiota community based on age, biological sex, and biopsy location was assessed through alpha and beta diversity metric calculations using phyloseq R package. RESULTS Sixty-two patients (24 female, 38 male) aged 18-80 years were recruited, resulting in 186 punch biopsy samples for analysis. Following removal of low-prevalence taxa, 606 ASVs were aggregated at the genus level, resulting in 214 genera across 13 phyla. The top 20 most abundant genera accounted for 73.5% of the overall sequence count. Cutibacterium was the most abundant genus within the study population, followed by Ralstonia, Staphylococcus, Bacteroides, and Streptococcus. Significant differences were observed in beta diversity metrics when comparing by biological sex, which accounted for 3.9%-5.3% of the variation in the microbial community, but not age or biopsy location. Males displayed a greater proportion of gram-positive and aerobic bacteria, whereas females exhibited a greater proportion of gram-negative and stress-tolerant bacteria. CONCLUSION This is the first study to look specifically at the microbiome of the cutaneous shoulder and describe the most abundant genera and compositional differences based on age, biological sex, and biopsy location. Biological sex was the only host covariant studied that reached significance in explaining microbiota variation. The top 20 most abundant genera, accounting for 74% of the overall sequence count, would be isolated with standard microbiological culture. As such, this study does not highlight a need to change current culture investigation practice for shoulder PJI, but it serves as an important catalog of skin commensals around the operative site in shoulder surgery.
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Affiliation(s)
- Eleanor Burden
- Royal Devon University Healthcare Foundation Trust, Exeter, UK.
| | - Yohannes Seyoum
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway
| | - Jonathan Peter Evans
- Royal Devon University Healthcare Foundation Trust, Exeter, UK; College of Medicine and Health, University of Exeter, Exeter, UK
| | - William Thomas
- Royal Devon University Healthcare Foundation Trust, Exeter, UK
| | - Jeffrey Kitson
- Royal Devon University Healthcare Foundation Trust, Exeter, UK
| | - Timothy Batten
- Gloucester Hospital NHS Foundation Trust, Gloucester, UK
| | - Rachel Patel
- Royal Devon University Healthcare Foundation Trust, Exeter, UK
| | - Mark van der Giezen
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger, Norway; Biosciences, University of Exeter, Exeter, UK; Research Department, Stavanger University Hospital, Stavanger, Norway
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Suparno S, Prasetyowati R, Aziz KN, Rahma A, Lestari ESA, Nabiilah SC, Grace D. Antibacterial Efficacy Comparison of Electrolytic and Reductive Silver Nanoparticles Against Propionibacterium acnes. Antibiotics (Basel) 2025; 14:86. [PMID: 39858370 PMCID: PMC11759858 DOI: 10.3390/antibiotics14010086] [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: 12/08/2024] [Revised: 01/06/2025] [Accepted: 01/09/2025] [Indexed: 01/27/2025] Open
Abstract
Background: The aim of this study was to develop an electrolysis system to produce silver nanoparticles free from toxic gases, as the most common reduction and electrolysis techniques produce nitrogen dioxide (NO2) as a byproduct, which is harmful to human health. The new electrolysis system used two identical silver plate electrodes, replacing silver and carbon rods, and used water as the electrolyte instead of silver nitrate (AgNO3) solution since AgNO3 is the source of NO2. Methods: The electrolytic silver nanoparticles (ESNs) produced by the new system were characterized and compared with reductive silver nanoparticles (RSNs). Using UV-Visible spectrophotometry, absorption peaks were found at 425 nm (ESN) and 437 nm (RSN). Using dynamic light scattering, the particle diameters were measured at 40.3 nm and 39.9 nm for ESNs at concentrations of 10 ppm and 30 ppm, respectively, and 74.0 nm and 74.6 nm for RSNs at concentrations of 10 ppm and 30 ppm, respectively. Antibacterial activity against Propionibacterium acnes (P. acnes) was assessed using the Kirby-Bauer method. Results: It was found that the efficacy of ESNs and RSNs was relatively lower than that of 5% chloramphenicol because it was measured in different concentration units (ESNs and RSNs in ppm and chloramphenicol in %). Using the calibration curve, the efficacy of 5% chloramphenicol was comparable to that of 0.005% ESN. It was also found that P. acnes developed a strong resistance to chloramphenicol and showed no resistance to ESNs. Conclusions: This finding underlines the tremendous potential of ESNs as a future antibiotic raw material.
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Affiliation(s)
- Suparno Suparno
- Department of Physics Education, Faculty of Mathematics and Science, Universitas Negeri Yogyakarta, 1st Colombo St., Karangmalang, Sleman, Yogyakarta 55281, Indonesia; (R.P.); (K.N.A.); (A.R.); (E.S.A.L.); (S.C.N.); (D.G.)
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De La Hoz-Romo MC, Díaz L, Gómez-León J, Quintero M, Villamil L. Marine actinobacteria metabolites: unlocking new treatments for acne vulgaris. Front Microbiol 2025; 15:1501951. [PMID: 39834363 PMCID: PMC11743623 DOI: 10.3389/fmicb.2024.1501951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2024] [Accepted: 11/26/2024] [Indexed: 01/22/2025] Open
Abstract
Marine-derived actinobacteria isolated from sponge Cliona varians and soft coral Eunicea fusca were screened for antibacterial activity against acne-related bacteria, specifically Staphylococcus epidermidis ATCC 14990, methicillin-resistant Staphylococcus aureus ATCC BAA44, and Cutibacterium acnes ATCC 6919. Cytotoxicity assays were performed on human dermal fibroblast (HDFa) and keratinocyte (HaCaT) cell lines to assess the safety profile of the extracts. Chemical characterization was conducted using high-performance liquid chromatography coupled with tandem mass spectrometry (HPLC-MS/MS). Among the extracts, six derived from Kocuria sp., Rhodococcus sp., Nocardia sp., Micrococcus sp., and Streptomyces sp. demonstrated significant antibacterial activity. Notably, extract Z9.216 from Kocuria sp. exhibited the highest efficacy, inhibiting S. epidermidis by 68%, S. aureus by 93%, and C. acnes by 98.7% at a concentration of 0.003 mg/mL, which was comparable to the standard antibiotics erythromycin and vancomycin, while maintaining over 90% cell viability in both HDFa and HaCaT cell lines. Untargeted metabolomic analysis suggested that antibacterial activity might be associated with compounds from the chemical families of alkaloids, terpenoids, and fatty acids, among others. These findings highlight the therapeutic potential of marine actinobacteria in underexplored environments as a promising strategy for treating acne vulgaris, a chronic inflammatory skin condition.
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Affiliation(s)
- María Clara De La Hoz-Romo
- Doctoral Program of Biosciences, School of Engineering, Universidad de La Sabana, Chía, Cundinamarca, Colombia
- Bioprospecting Research Group, School of Engineering, Universidad de La Sabana, Chía, Colombia
| | - Luis Díaz
- Doctoral Program of Biosciences, School of Engineering, Universidad de La Sabana, Chía, Cundinamarca, Colombia
- Bioprospecting Research Group, School of Engineering, Universidad de La Sabana, Chía, Colombia
| | - Javier Gómez-León
- Marine Bioprospecting Line, Marine and Coastal Research Institute “José Benito Vives de Andréis” INVEMAR, Santa Marta, Colombia
| | - Marynes Quintero
- Marine Bioprospecting Line, Marine and Coastal Research Institute “José Benito Vives de Andréis” INVEMAR, Santa Marta, Colombia
| | - Luisa Villamil
- Doctoral Program of Biosciences, School of Engineering, Universidad de La Sabana, Chía, Cundinamarca, Colombia
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12
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Zhang L, Li F, Zhao D, Duan L, Bai W, Yan B. Research trends and focus of prosthetic joint infections from 2013 to 2023: bibliometric and visualization studies. Front Microbiol 2024; 15:1507340. [PMID: 39760080 PMCID: PMC11695429 DOI: 10.3389/fmicb.2024.1507340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2024] [Accepted: 11/25/2024] [Indexed: 01/07/2025] Open
Abstract
Background Postoperative infections in artificial joints provide considerable difficulties in the field of orthopedics, especially after joint replacement procedures. These infections rank among the most severe postoperative consequences, frequently leading to treatment ineffectiveness and reduced quality of life for surgery patients. Consequently, it is crucial to acquire knowledge about worldwide research trends in this area in order to educate clinical practices and improve therapeutic techniques. This work exploits bibliometric analysis to investigate the present state, developing patterns, and main areas of focus in research on artificial joint infection. Objective To analyze the research trends, hotspots, and international collaborations on artificial joint infections worldwide from 2013 to 2023. Methods Extractions of raw data were made from the WoSCC (Web of Science Core Collection) database. Detailed information collected includes the quantity of publications, authors, citations, publication year, h-index, references, country/region, journal, and keywords. Analysis of the data was conducted using VOSviewer version 1.6.10.0 and CiteSpace version 6.3.R1. Results A total of 1,799 articles published between 2013 and 2023 were included in this analysis, showing a steady increase in publication with the United States leading at 553 articles. Infection rates and topics such as biofilm formation and antimicrobial resistance were highly cited, with Mayo Clinic contributing 65 articles as the most prolific institution. Conclusion Research on biofilm infections, antibiotic resistance, and new biomarkers is a key focus, particularly on disrupting biofilms and enhancing diagnostics. There's growing attention in biomarkers like α-defensins and exosomal miRNAs for PJI diagnosis, pointing to new clinical uses. Studies on antimicrobial-coated prosthetics and topical agents are also gaining importance in treatment strategies.
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Affiliation(s)
- Liwen Zhang
- The First Clinical Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fei Li
- Department of Orthopedics, Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, China
| | - Diqian Zhao
- The First Clinical Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Lei Duan
- The First Clinical Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wenzhe Bai
- The First Clinical Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China
- Department of Orthopedics, Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, China
| | - Bing Yan
- Department of Orthopedics, Affiliated Hospital of Shandong Traditional Chinese Medicine University, Jinan, China
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Kaplan JB, Assa M, Mruwat N, Sailer M, Regmi S, Kridin K. Facultatively Anaerobic Staphylococci Enable Anaerobic Cutibacterium Species to Grow and Form Biofilms Under Aerobic Conditions. Microorganisms 2024; 12:2601. [PMID: 39770803 PMCID: PMC11678309 DOI: 10.3390/microorganisms12122601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2024] [Revised: 12/09/2024] [Accepted: 12/13/2024] [Indexed: 01/11/2025] Open
Abstract
Facultatively anaerobic Staphylococcus spp. and anaerobic Cutibacterium spp. are among the most prominent bacteria on human skin. Although skin microbes generally grow as multispecies biofilms, few studies have investigated the interaction between staphylococci and Cutibacterium spp. in dual-species biofilms. Here, we measured the mono- and dual-species biofilm formation of four staphylococcal species (S. epidermidis, S. hominis, S. capitis, and S. aureus) and two Cutibacterium spp. (C. acnes and C. avidum) cultured in vitro under both aerobic and anaerobic conditions. The biofilms were quantitated by rinsing them to remove planktonic cells, detaching the biofilm bacteria via sonication, and enumerating the cells by dilution plating. When cultured alone, staphylococci formed biofilms under both aerobic and anaerobic conditions, whereas Cutibacterium spp. formed biofilms only under anaerobic conditions. In co-culture, staphylococcal biofilm formation was unaffected by the presence of Cutibacterium spp., regardless of oxygen availability. However, Cutibacterium spp. biofilm formation was significantly enhanced in the presence of staphylococci, enabling robust growth under both anaerobic and aerobic conditions. Fluorescence confocal microscopy of the aerobic dual-species biofilms suggested that staphylococci create anaerobic niches at the base of the biofilm where C. acnes can grow. These findings demonstrate that staphylococci facilitate the colonization of Cutibacterium spp. in oxygen-rich environments, potentially explaining their presence in high numbers on the oxygen-exposed stratum corneum.
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Affiliation(s)
- Jeffrey B. Kaplan
- Laboratory for Skin Research, Institute for Medical Research, Galilee Medical Center, Nahariya 2210001, Israel; (N.M.); (K.K.)
| | - Michael Assa
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel;
| | - Noor Mruwat
- Laboratory for Skin Research, Institute for Medical Research, Galilee Medical Center, Nahariya 2210001, Israel; (N.M.); (K.K.)
| | - Miloslav Sailer
- Kane Biotech Inc., Winnipeg, MB R3T 6G2, Canada; (M.S.); (S.R.)
| | - Suresh Regmi
- Kane Biotech Inc., Winnipeg, MB R3T 6G2, Canada; (M.S.); (S.R.)
| | - Khalaf Kridin
- Laboratory for Skin Research, Institute for Medical Research, Galilee Medical Center, Nahariya 2210001, Israel; (N.M.); (K.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel;
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14
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Wahl P, Drennan P, Schläppi M, Achermann Y, Leunig M, Gautier E, Benninger E. Systemic antibiotic prophylaxis in arthroplasty - a narrative review of how many doses are optimal. EFORT Open Rev 2024; 9:1106-1119. [PMID: 39620563 PMCID: PMC11619733 DOI: 10.1530/eor-24-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2024] Open
Abstract
Systemic antibiotic prophylaxis (SAP) is well-established in arthroplasty to prevent periprosthetic joint infection. However, the optimal duration and dosing of SAP remain a matter of debate, as evidenced by ongoing discordance between recommendations and clinical practice, reflected in the heterogeneity and imprecision of national and societal guidelines. The evidence currently available regarding the duration of SAP is summarised and discussed, specifically the postoperative repeated administration of antimicrobials within the first 24 h. The evidence available suffers from limitations, specifically deficiencies in outcome assessments in the available randomised controlled trials. Observational studies suggest that a short postoperative prolongation (<24 h) of SAP in arthroplasty may result in superior long-term outcomes compared to a single dose, and that an optimal dosing strategy, which warrants further prospective evaluation, may involve 'stacked dosing' in the early postoperative period, with re-administration every two half-lives when using commonly recommended beta-lactam antibiotics, instead of repetition at usual dosing intervals over 24 h. A stacked approach would also cover recognised indications for repetition, such as major blood loss and increased duration of operation, potentially simplifying prescribing protocols. Pharmacokinetic simulations are provided to illustrate the distinct concentration-time profiles associated with different prophylaxis regimens. Prolonging SAP beyond 24 h is not recommended. This review concludes by providing recommendations for further research, particularly a call to document SAP regimens with sufficient detail (choice of drug, dose regimen, and duration of administration) into established national arthroplasty registries, which should rapidly enable a significantly more nuanced understanding of these critical issues than permitted by the current literature.
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Affiliation(s)
- Peter Wahl
- Division of Orthopaedics and Traumatology, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Philip Drennan
- Kennedy Institute, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Michel Schläppi
- Division of Orthopaedics and Traumatology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Yvonne Achermann
- Department of Internal Medicine, Hospital Zollikerberg, Zurich, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Michael Leunig
- Department of Orthopedics, Schulthess Clinic, Zurich, Switzerland
| | - Emanuel Gautier
- Department of Orthopaedics, HFR Fribourg – Cantonal Hospital, Fribourg, Switzerland
| | - Emanuel Benninger
- Division of Orthopaedics and Traumatology, Cantonal Hospital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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15
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Sewpaul Y, Huynh R, Leung B, Alcock H, Nayar SK, Rashid MS. Topical Preparations for Reducing Cutibacterium acnes Infections in Shoulder Surgery: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Am J Sports Med 2024; 52:3662-3672. [PMID: 38590237 DOI: 10.1177/03635465231223877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND Cutibacterium acnes (C acnes) is a commensal skin bacterium, primarily found in sebaceous glands and hair follicles, with a high prevalence in the shoulder region. It is the most common pathogenic organism in prosthetic joint infections after shoulder arthroplasty. Because of its low virulence, its diagnosis remains difficult. PURPOSE To evaluate the relative effects of topical preparations in reducing C acnes in shoulder surgery. STUDY DESIGN Meta-analysis; Level of evidence, 1. METHODS We searched the MEDLINE, Embase, PsychINFO, and Cochrane Library databases in March 2022. Randomized controlled trials (RCTs) comparing any form of topical preparation in arthroscopic or open shoulder surgery were included. The primary outcome was a reduction in the number of positive C acnes cultures. Secondary outcomes were adverse events related to the application of topical preparations. We performed a network meta-analysis to facilitate simultaneous comparisons between multiple preparations across studies. We calculated differences between preparations using odds ratios and their 95% CIs. The risk of bias was assessed using the Cochrane risk-of-bias tool. RESULTS The search yielded 17 RCTs (1350 patients), of which 9 were suitable for the network meta-analysis (775 patients). Overall, 2 RCTs were deemed as having a low risk of bias, and 15 raised "some concerns" of bias. Preparations included benzoyl peroxide (BPO), BPO combined with clindamycin, chlorhexidine gluconate, hydrogen peroxide, povidone-iodine, and water with soap. Only BPO resulted in significantly lower odds of a positive C acnes culture compared with placebo or soap and water (odds ratio, 0.12 [95% CI, 0.04-0.36]). There was no statistically significant difference with all other topical preparations. The only adverse events were skin irritation from BPO and chlorhexidine gluconate in a small number of reported cases. CONCLUSION BPO was the most effective topical agent in reducing the prevalence of C acnes in shoulder surgery. These results were limited by a combination of indirect and direct data. Future studies should focus on establishing the optimal frequency and duration of preoperative BPO to further reduce the burden of C acnes. REGISTRATION CRD42022310312 (PROSPERO).
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Affiliation(s)
- Yash Sewpaul
- Lancaster University Medical School, Lancaster, UK
| | - Richard Huynh
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Brook Leung
- Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Harry Alcock
- Nottingham University Hospitals NHS Trust, Nottingham, UK
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16
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Yoon JP, Lee KS, Park SJ, Kim DH, Kim J, Choi YS, Lee HJ, Chung SW. Cutibacterium acnes in Shoulder Surgery: Is It a Significant Risk Factor for Postoperative Infection? Clin Orthop Surg 2024; 16:845-853. [PMID: 39618529 PMCID: PMC11604557 DOI: 10.4055/cios23371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 12/13/2024] Open
Abstract
Cutibacterium acnes, a commensal, lipophilic, anaerobic Gram-positive bacterium, is well known for its potential to cause infections, particularly in the field of orthopedics, notably in the shoulder. However, its indolent strain nature presents challenges in the diagnosis of the bacterium using clinical, laboratory, and culture-based methods. There are controversies surrounding its actual threat as an infection-causing agent, leading to an incomplete consensus on treatment strategies after the infection. Furthermore, research is ongoing to explore preventive procedures before the onset of infection. This review aimed to comprehensively explore the diagnosis and treatment of C. acnes and determine whether it is a risk factor for shoulder joint infections.
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Affiliation(s)
- Jong Pil Yoon
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Kang-San Lee
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Sung-Jin Park
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Dong-Hyun Kim
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Junsung Kim
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Yoon Seong Choi
- Department of Carbon Hybrid Fiber Science, Kyungpook National University, Daegu, Korea
| | - Hyun Joo Lee
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
| | - Seok Won Chung
- Department of Orthopedic Surgery, Konkuk University Medical Center, Seoul, Korea
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17
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Duffy HR, Ashton NN, Blair A, Hooper N, Stulce P, Williams DL. Regulatory Standard for Determining Preoperative Skin Preparation Efficacy Underreports True Dermal Bioburden in a Porcine Model. Microorganisms 2024; 12:2369. [PMID: 39597757 PMCID: PMC11596398 DOI: 10.3390/microorganisms12112369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 11/01/2024] [Accepted: 11/07/2024] [Indexed: 11/29/2024] Open
Abstract
Medical device companies and regulatory bodies rely on a nondestructive bacterial sampling technique specified by the American Society for Testing and Materials (ASTM E1173-15) to test preoperative skin preparations (PSPs). Despite the widespread use of PSPs, opportunistic skin-flora pathogens remain the most significant contributor to surgical site infections, suggesting that the ASTM testing standard may be underreporting true dermal bioburden. We hypothesized that ASTM E1173-15 may fail to capture deep skin-dwelling flora. To test this hypothesis, we applied ASTM E1173-15 and a full-thickness skin sampling technique, which we established previously through application to the backs of seven pigs (Yorkshire/Landrace hybrid) following a clinically used PSP (4% chlorhexidine gluconate). The results showed that samples quantified using the full-thickness skin method consistently cultured more bacteria than the ASTM standard, which principally targeted surface-dwelling bacteria. Following PSP, the ASTM standard yielded 1.05 ± 0.24 log10 CFU/cm2, while the full-thickness tissue method resulted in 3.24 ± 0.24 log10 CFU/cm2, more than a 2 log10 difference (p < 0.001). Immunofluorescence images corroborated the data, showing that Staphylococcus epidermidis was present in deep skin regions with or without PSP treatment. Outcomes suggested that a full-thickness sampling technique may better evaluate PSP technologies as it resolves bioburdens dwelling in deeper skin regions.
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Affiliation(s)
- Hannah R. Duffy
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (A.B.); (N.H.); (P.S.)
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Nicholas N. Ashton
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (A.B.); (N.H.); (P.S.)
| | - Abbey Blair
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (A.B.); (N.H.); (P.S.)
| | - Nathanael Hooper
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (A.B.); (N.H.); (P.S.)
| | - Porter Stulce
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (A.B.); (N.H.); (P.S.)
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
| | - Dustin L. Williams
- Department of Orthopaedics, University of Utah, Salt Lake City, UT 84112, USA; (H.R.D.); (N.N.A.); (A.B.); (N.H.); (P.S.)
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA
- Department of Pathology, University of Utah, Salt Lake City, UT 84112, USA
- Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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18
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Haq K, Figgitt M, Lee D. Phage Therapy Against Antibiotic-Resistant and Multidrug-Resistant Infections Involving Nonhealing Wounds and Prosthetic Joint Infections Associated With Biofilms: A Mini-Review. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2024; 2024:6252415. [PMID: 39545100 PMCID: PMC11563716 DOI: 10.1155/2024/6252415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Accepted: 10/24/2024] [Indexed: 11/17/2024]
Abstract
Chronic wounds and prosthetic joint infections are difficult to treat and are associated with a high burden of disease and economic cost. The rise of antibiotic resistance and the understanding of biofilm formation has inflamed an already challenging situation. Bacteriophage therapy has been used throughout the last century to treat bacterial infections. However, in the last 10 years, there has been a resurgence in phage therapy as a novel innovative treatment for nonhealing wounds. This mini systemic review assesses relevant clinical studies, case series and trials over 5 years associated with safety, treatment and success rates of phage therapy concerning nonhealing and prosthetic joint infections. A search of PubMed, Web of Science, Cochrane and Clinical Trials.gov databases resulted in 3151 studies, 27 met the criteria, and a total of 152 bacterial infections were treated from 130 individuals. Most common pathogen isolated in wounds was P. aeruginosa, and S. aureus was mostly associated with prosthetic joint infections. Treatment modalities differed across studies, adverse effects were limited, and success rate was deemed to be 91%.
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Affiliation(s)
- Kashif Haq
- Department of Life Sciences, School of Health Sciences, Birmingham City University, Birmingham B15 3TN, UK
| | - Martin Figgitt
- Department of Life Sciences, School of Health Sciences, Birmingham City University, Birmingham B15 3TN, UK
| | - David Lee
- Department of Life Sciences, School of Health Sciences, Birmingham City University, Birmingham B15 3TN, UK
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19
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Liew-Littorin C, Davidsson S, Nilsdotter-Augustinsson Å, Hellmark B, Brüggemann H, Söderquist B. Genomic characterization and clinical evaluation of prosthetic joint infections caused by Cutibacterium acnes. Microbiol Spectr 2024; 12:e0030324. [PMID: 39377601 PMCID: PMC11537072 DOI: 10.1128/spectrum.00303-24] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 08/16/2024] [Indexed: 10/09/2024] Open
Abstract
Cutibacterium acnes is a major skin commensal that may act as an opportunistic pathogen. It is difficult to interpret findings of C. acnes in tissue cultures obtained during arthroplasty revision surgery, since they may represent true infection or contamination. This study investigated whether C. acnes obtained from prosthetic joint infections (PJIs) were related and shared common genomic traits that might correlate with clinical courses and patient outcomes. C. acnes isolates from revision surgery of patients with PJIs of the hip, shoulder, and knee were characterized using molecular methods to determine the sequence type (ST) and the presence of possible virulence determinants (Christie-Atkins-Munch-Peterson factors, dermatan sulfate-binding adhesion 1, hyaluronidase lyase, and linear plasmid). A standardized review of the patients' medical charts was performed. The study included 37 patients with C. acnes culture-positive tissue samples where multiple isolates of C. acnes belonged to the same ST. Most of the isolates belonged to phylotype IA1. Phylogenetic analysis of virulence determinants revealed no shared pattern among PJI isolates. Seven patients had a polymicrobial infection. Exchange revision was performed in 70% of the patients, and >50% of all patients received antibiotic treatment for ≥3 months. Failure was noted in seven patients. No specific ST or any identifiable unique feature among virulence determinants were found among C. acnes isolated from PJIs of hips and shoulders. The majority of patients had low inflammatory markers and were treated successfully, even polymicrobial infections. However, failure was more common among shoulder infections compared with hip infections. IMPORTANCE Prosthetic joint infection (PJI) is a rare complication after arthroplasty surgery. The infection seldom resolves without a combination of both surgical and antibiotic treatment and can cause significant suffering among affected patients. Cutibacterium acnes is a common skin bacterium that is most often found in shoulder PJIs but can also infect other prostheses. In this study, we conducted a review of patients with previously verified PJIs involving C. acnes in hip or shoulder prostheses, along with a genomic analysis of the bacteria causing the infections. The majority of patients had successful outcomes. We did not identify any specific phylogenetic lineage or specific molecular signature of virulence factors among these PJI-associated C. acnes isolates that seemed to be associated with increased potential to cause infection among this species. This indicates that C. acnes isolated from PJIs originates from the patients' own skin microbiome and is inoculated during the arthroplasty surgery.
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Affiliation(s)
- C. Liew-Littorin
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - S. Davidsson
- Department of Urology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Å. Nilsdotter-Augustinsson
- Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Östergötland, Sweden
| | - B. Hellmark
- Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - H. Brüggemann
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - B. Söderquist
- Department of Laboratory Medicine, Clinical Microbiology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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20
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Ruffier d'Epenoux L, Fayoux E, Veziers J, Dagnelie MA, Khammari A, Dréno B, Corvec S. Biofilm of Cutibacterium acnes: a target of different active substances. Int J Dermatol 2024; 63:1541-1550. [PMID: 38760974 DOI: 10.1111/ijd.17194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Acne vulgaris is a chronic inflammatory dermatosis. Cutibacterium acnes plays a crucial role in the acne pathophysiology. Recent works present evidence of C. acnes growing as a biofilm in cutaneous follicles. This development is currently considered one of the leading causes of C. acnes in vivo persistence and resistance to antimicrobials used to treat acne. OBJECTIVE Our objective was to evaluate the effects of various active compounds (clindamycin, erythromycin, doxycycline, and myrtle extract) on eight distinct, well-characterized strains of C. acnes following their growth in biofilm mode. METHODS/RESULTS Cutibacterium acnes isolates from phylotypes IA1 and IA2 produce more biofilm than other phylotypes. No antibiotic effect was observed either during the curative test or preventive test. Myrtle extract at 0.01% (w/v) showed significant efficacy on the biofilm for C. acnes strains (curative assays). Furthermore, it appear that myrtle extract and doxycycline together reduce the overall biomass of the biofilm. A significant dose-dependent effect was observed during the preventive test, greater than the one observed under curative conditions, with an important loss of activity of the myrtle extract observed from 0.001% (w/v) concentration onwards. Transmission electron microscopy showed that bacteria treated with myrtle extract grew biofilms much less frequently than untreated bacteria. Additionally, when the quantity of myrtle extract grew, the overall number of bacteria dropped, indicating an additional antibacterial action. CONCLUSION These findings support the hypothesis that the different C. acnes phylotypes have various aptitudes in forming biofilms. They also suggest that myrtle extract is a promising alternative as an anti-biofilm and antibacterial agent in fighting diseases caused by planktonic and biofilm C. acnes.
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Affiliation(s)
- Louise Ruffier d'Epenoux
- Service de Bactériologie et des Contrôles Microbiologiques, CHU, Nantes, France
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Erwan Fayoux
- Service de Bactériologie et des Contrôles Microbiologiques, CHU, Nantes, France
| | - Joëlle Veziers
- Inserm, UMR 1229, RMeS - Regenerative Medicine and Skeleton, Université de Nantes, ONIRIS, Nantes, France
| | - Marie-Ange Dagnelie
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Amir Khammari
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Brigitte Dréno
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
| | - Stéphane Corvec
- Service de Bactériologie et des Contrôles Microbiologiques, CHU, Nantes, France
- Université de Nantes, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT UMR 1302/EMR6001, Nantes, France
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21
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Hsu JE, Matsen FA, Whitson AJ, Waalkes A, Almazan J, Bourassa LA, Salipante SJ, Long DR. 2023 Neer Award for Basic Science: Genetics of Cutibacterium acnes in revision shoulder arthroplasty: a large-scale bacterial whole-genome sequencing study. J Shoulder Elbow Surg 2024; 33:2400-2410. [PMID: 38604398 PMCID: PMC11663454 DOI: 10.1016/j.jse.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/24/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND Cutibacterium acnes is the bacterium most commonly responsible for shoulder periprosthetic joint infection (PJI) and is often cultured from samples obtained at the time of revision for failed shoulder arthroplasty. We sought to determine whether these bacteria originate from the patient or from exogenous sources. We also sought to identify which C. acnes genetic traits were associated with the development of shoulder PJI. METHODS We performed bacterial whole-genome sequencing of C. acnes from a single-institution repository of cultures obtained before or during primary and revision shoulder arthroplasty and correlated the molecular epidemiology and genetic content of strains with clinical features of infection. RESULTS A total of 341 isolates collected over a 4-year period from 88 patients were sequenced. C. acnes cultured from surgical specimens demonstrated significant similarity to the strains colonizing the skin of the same patient (P < .001). Infrequently, there was evidence of strains shared across unrelated patients, suggesting that exogenous sources of C. acnes culture-positivity were uncommon. Phylotypes IB and II were modestly associated with clinical features of PJI, but all phylotypes appeared inherently capable of causing disease. Chronic shoulder PJI was associated with the absence of common C. acnes genes involved in bacterial quorum-sensing (luxS, tqsA). CONCLUSION C. acnes strains cultured from deep intraoperative sources during revision shoulder arthroplasty demonstrate strong genetic similarity to the strains colonizing a patient's skin. Some phylotypes of C. acnes commonly colonizing human skin are modestly more virulent than others, but all phylotypes have a capacity for PJI. C. acnes cultured from cases of PJI commonly demonstrated genetic hallmarks associated with adaptation from acute to chronic phases of infection. This is the strongest evidence to date supporting the role of the patient's own, cutaneous C. acnes strains in the pathogenesis of shoulder arthroplasty infection. Our findings support the importance of further research focused on perioperative decolonization and management of endogenous bacteria that are likely to be introduced into the arthroplasty wound at the time of skin incision.
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Affiliation(s)
- Jason E Hsu
- Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA.
| | - Frederick A Matsen
- Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Anastasia J Whitson
- Department of Orthopaedics and Sports Medicine, University of Washington Medical Center, Seattle, WA, USA
| | - Adam Waalkes
- Department of Laboratory Medicine & Pathology, University of Washington Medical Center, Seattle, WA, USA
| | - Jared Almazan
- Department of Laboratory Medicine & Pathology, University of Washington Medical Center, Seattle, WA, USA
| | - Lori A Bourassa
- Department of Laboratory Medicine & Pathology, University of Washington Medical Center, Seattle, WA, USA
| | - Stephen J Salipante
- Department of Laboratory Medicine & Pathology, University of Washington Medical Center, Seattle, WA, USA
| | - Dustin R Long
- Department of Anesthesiology & Pain Medicine, University of Washington Medical Center, Seattle, WA, USA
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22
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Kuzmin D, Feigl GC. Propionibacterium acnes: A Difficult-to-Diagnose Ventriculoperitoneal Shunt Infection. Case Report. J Neurol Surg A Cent Eur Neurosurg 2024; 85:622-624. [PMID: 37595626 DOI: 10.1055/a-2156-5520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
BACKGROUND Ventriculoperitoneal (VP) shunt infections are a fairly common complication in both the early and late postoperative periods. Sometimes diagnosis is difficult despite the fact that infection is often accompanied by clinical symptoms. Furthermore, pathogenic bacteria can be detected in the cerebrospinal fluid. METHOD We describe a case of chronic VP shunt infection in a 24-year-old female patient who was operated on for posterior fossa pilocytic astrocytoma and needed a VP shunt. The infection revealed itself 5 years after shunt implantation with nonspecific symptoms, and it took approximately 2 years to make a correct diagnosis. Meanwhile, the patient's condition became critical. The infection was caused by Propionibacterium acnes, which is capable of forming biofilms on implants, and which is difficult to identify due to the peculiarity of its cultivation. RESULT When the bacterium was identified, the shunt was replaced and antimicrobial therapy was performed, after which the patient's condition improved dramatically and she got back to her normal life. CONCLUSIONS This case shows how difficult the diagnosis of VP shunt infection can be and what clinical significance it can have for the patient.
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Affiliation(s)
- Dzmitry Kuzmin
- Department of Neurosurgery, General Hospital Bamberg, Bamberg, Germany
| | - Guenther C Feigl
- Department of Neurosurgery, General Hospital Bamberg, Bamberg, Germany
- Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
- Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas
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23
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Botros M, de Mesy Bentley KL, Schloemann DT, Saito M, Constantine R, Ricciardi BF, Muthukrishnan G. Cutibacterium acnes invades submicron osteocyte lacuno-canalicular networks following implant-associated osteomyelitis. J Orthop Res 2024; 42:2593-2603. [PMID: 39044717 DOI: 10.1002/jor.25929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/12/2024] [Accepted: 06/18/2024] [Indexed: 07/25/2024]
Abstract
Cutibacterium acnes, part of normal skin flora, is increasingly recognized as an opportunistic pathogen capable of causing chronic prosthetic joint infections (PJI) associated with total hip and knee arthroplasty. However, there is a paucity of literature examining the pathogenesis of C. acnes during PJI. To study this, we developed an implant-associated osteomyelitis murine model in which 8-10-week-old C57BL6 mice were subjected to transtibial implantation of titanium or stainless-steel L-shaped pins contaminated with C. acnes. Postsurgery, mice were killed on Days 14 and 28 for terminal assessments of (1) bacterial load in bone, implant, and internal organs (heart, spleen, kidney, and liver), (2) bone osteolysis (micro-CT), (3) abscess formation (histology), and (4) systematic electron microscopy (EM). In vitro scanning EM (SEM) confirmed that C. acnes can form biofilms on stainless-steel and titanium implants. In mice, C. acnes could persist for 28 days in the tibia. Also, we observed C. acnes dissemination to internal organs. C. acnes chronic osteomyelitis revealed markedly reduced bone osteolysis and abscess formation compared to Staphylococcus aureus infections. Importantly, transmission EM (TEM) investigation revealed the presence of C. acnes within canaliculi, demonstrating that C. acnes can invade the osteocyte lacuno-canalicular networks (OLCN) within bone. Our preliminary pilot study, for the first time, revealed that the OLCN in bone can be a reservoir for C. acnes and potentially provides a novel mechanism of why C. acnes chronic implant-associated bone infections are difficult to treat.
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Affiliation(s)
- Mina Botros
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Karen L de Mesy Bentley
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Derek T Schloemann
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Motoo Saito
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Robert Constantine
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Benjamin F Ricciardi
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
| | - Gowrishankar Muthukrishnan
- Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, New York, USA
- Department of Orthopaedics, University of Rochester Medical Center, Rochester, New York, USA
- Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, New York, USA
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Lomakin IB, Devarkar SC, Grada A, Bunick CG. Mechanistic Basis for the Translation Inhibition of Cutibacterium acnes by Clindamycin. J Invest Dermatol 2024; 144:2553-2561.e3. [PMID: 39122144 DOI: 10.1016/j.jid.2024.07.013] [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: 06/06/2024] [Revised: 07/11/2024] [Accepted: 07/13/2024] [Indexed: 08/12/2024]
Abstract
Inflammation and the Gram-positive anaerobic bacterium Cutibacterium acnes, which is implicated in acne pathogenesis and pilosebaceous-unit inflammation, are the main targets of antibiotic-based therapy against acne vulgaris (acne). The most widely used antibiotics in acne therapy are tetracyclines, macrolides, and lincosamides. Unfortunately, C. acnes bacteria over the past several decades have demonstrated increased resistance to these antibiotics, particularly to clindamycin. The precise knowledge of how antibiotics interact with their clinical target is needed to overcome this problem. Toward this goal, we determined the structure of clindamycin in complex with the ribosome of C. acnes at 2.53 Å resolution using cryogenic electron microscopy. The galactose sugar moiety of clindamycin interacts with nucleotides of the 23S ribosomal RNA directly or through a conserved network of water-mediated interactions. Its propyl pyrrolidinyl group interacts with the 23S ribosomal RNA through van der Waals forces. Clindamycin binding to the C. acnes ribosome interferes with both: proper orientation of the aminoacyl group of the A-site bound transfer RNA that is needed for peptide bond formation and with the extension of the nascent peptide. Our data are important for advancing the understanding of antibiotic resistance and development of narrow-spectrum antibacterial drugs, which is an urgent need for contemporary antibiotic stewardship.
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Affiliation(s)
- Ivan B Lomakin
- Department of Dermatology, Yale University, New Haven, Connecticut, USA.
| | - Swapnil C Devarkar
- Department of Molecular Biophysics and Biochemistry, Yale University, New Haven, Connecticut, USA
| | - Ayman Grada
- Department of Dermatology, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Christopher G Bunick
- Department of Dermatology, Yale University, New Haven, Connecticut, USA; Program in Translational Biomedicine, Yale University School of Medicine, New Haven, Connecticut, USA.
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25
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Scheer VM, Scheer JH, Kalén A, Serrander L. Occlusive wound dressings: A greenhouse for bacteria? J Infect Prev 2024; 25:242-246. [PMID: 39493589 PMCID: PMC11528567 DOI: 10.1177/17571774241261923] [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: 06/14/2023] [Accepted: 05/06/2024] [Indexed: 11/05/2024] Open
Abstract
Background The modern wound dressing is produced to absorb fluid and protect against external contamination. The choice of which wound dressing to apply after surgery is usually based on local tradition. There are various impervious dressings on the market. Even if the wound is sterile before application, there will be subsequent recolonisation of skin microbiota. Previous studies suggest that a high bacterial load on the skin hampers wound healing and might be a risk for SSI. Aim The aim was to compare bacterial recolonisation on the shoulder under three different wound dressings, 48 h after sterile preparation of the skin as in preparation for surgery. Method In 25 healthy volunteers, a standard pre-surgical skin disinfection for a deltopectoral incision was made on the left shoulder with 0.5% chlorhexidine solution in 70% ethanol. Three different wound dressings were then placed on the shoulder, and 48 h later the skin beneath each dressing was swabbed, subsequently cultured and bacterial density analysed using viable count. Results The bacterial recolonisation under air-dry (gauze) dressing was significantly lower (p = .0001) compared to semipermeable and occlusive wound dressings. Conclusion Choosing a less permeable wound dressing may lead to an increased bacterial load on the skin during the first 48 h after surgery.
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Affiliation(s)
- Vendela M Scheer
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Johan H Scheer
- Department of Orthopedics, Department of Biomedical and Clinical Sciences, Linkoping University Faculty of Medicine, Linköping, Sweden
| | - Anders Kalén
- Department of Orthopedics, Department of Biomedical and Clinical Sciences, Linkoping University Faculty of Medicine, Linköping, Sweden
| | - Lena Serrander
- Division of Clinical Microbiology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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26
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Podbielski A, Köller T, Warnke P, Barrantes I, Kreikemeyer B. Whole genome sequencing distinguishes skin colonizing from infection-associated Cutibacterium acnes isolates. Front Cell Infect Microbiol 2024; 14:1433783. [PMID: 39512589 PMCID: PMC11540793 DOI: 10.3389/fcimb.2024.1433783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 09/23/2024] [Indexed: 11/15/2024] Open
Abstract
Introduction Cutibacterium acnes can both be a helpful colonizer of the human skin as well as the causative agent of acne and purulent infections. Until today, it is a moot point whether there are C. acnes strains exclusively devoted to be part of the skin microbiome and others, that carry special features enabling them to cause disease. So far, the search for the molecular background of such diverse behavior has led to inconsistent results. Methods In the present study, we prospectively collected C. acnes strains from 27 infected persons and 18 healthy controls employing rigid selection criteria to ensure their role as infectious agent or colonizer. The genome sequences from these strains were obtained and carefully controlled for quality. Results Deduced traditional phylotyping assigned almost all superficial isolates to type IA1, while the clinical strains were evenly distributed between types IA1, IB, and II. Single locus sequence typing (SLST) showed a predominance of A1 type for the control strains, whereas 56% of the clinical isolates belonged to types A1, H1 and K8. Pangenome analysis from all the present strains and 30 published genomes indicated the presence of an open pangenome. Except for three isolates, the colonizing strains clustered in clades separate from the majority of clinical strains, while 4 clinical strains clustered with the control strains. Identical results were obtained by a single nucleotide polymorphism (SNP) analysis. However, there were no significant differences in virulence gene contents in both groups. Discussion Genome-wide association studies (GWAS) from both the pangenome and SNP data consistently showed genomic differences between both groups located in metabolic pathway and DNA repair genes. Thus, the different behavior of colonizing and infectious C. acnes strains could be due to special metabolic capacities or flexibilities rather than specific virulence traits.
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Affiliation(s)
- Andreas Podbielski
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
| | - Thomas Köller
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
| | - Philipp Warnke
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
| | - Israel Barrantes
- Research Group Translational Bioinformatics, Institute for Biostatistics and Informatics in Medicine and Aging Research, Rostock University Medical Center, Rostock, Germany
| | - Bernd Kreikemeyer
- Institute of Medical Microbiology, Virology and Hygiene, Rostock University Medical Center, Rostock, Germany
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Liu BQ, Bai Y, Chen DP, Zhang YM, Wang TZ, Chen JR, Liu XY, Zheng B, Cui ZL. Intratumoural microorganism can affect the progression of hepatocellular carcinoma. World J Gastrointest Oncol 2024; 16:4232-4243. [DOI: 10.4251/wjgo.v16.i10.4232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2024] [Revised: 07/29/2024] [Accepted: 08/12/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Several recent studies have confirmed that intratumoural microorganisms can affect the occurrence and development of hepatocellular carcinoma (HCC); however, their role in tumor progression remains unclear. Hence, there is a need for further research on the role of intratumoural microorganisms in HCC.
AIM To investigate the changes in intratumoural microorganisms in HCC and the effect of Propionibacterium on HCC progression.
METHODS HCC and normal liver tissue specimens were subjected to fluorescence in situ hybridization (FISH). After performing 16S rRNA sequencing on HCC and peritumoral tissues to analyze the differences between the two groups. Propionibacterium was cocultured with HCC cells in vitro. Changes in cell proliferation and migration capacity were evaluated. The expression of NF-κB pathway related proteins in tumor cells was compared. The orthotopic liver implantation model and the subcutaneous xenograft model were constructed. liver tissues and subcutaneous tumors were collected 2 weeks later.
RESULTS FISH demonstrated the presence of microorganisms in HCC and normal liver tissues. 16S rRNA sequencing revealed an abundance of Lysobacter, Lachnospiraceae, Pseudomonas, and Lactobacillus in HCC tissues. The distribution and abundance of Propionibacterium showed differences between HCC and peritumoral tissues (P < 0.05). In vitro studies demonstrated that Propionibacterium and its metabolite propionic acid (PA) inhibited the proliferation and migration of HCC cells (P < 0.05). The expression of the proteins in NF-κB signaling pathway also decreased in HCC cells (P < 0.05).
CONCLUSION Microorganisms in HCC and normal liver tissues displayed significant disparities. The PA-producing bacterium Propionibacterium in HCC exerts an effect on the NF-κB pathway, thereby affecting the biological behavior of HCC.
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Affiliation(s)
- Bao-Qun Liu
- First Central Clinical College, Tianjin Medical University, Tianjin 300070, China
| | - Yi Bai
- Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
| | - Da-Peng Chen
- First Central Clinical College, Tianjin Medical University, Tianjin 300070, China
| | - Ya-Min Zhang
- Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
| | - Tian-Ze Wang
- Tianjin First Central Hospital Clinic Institute, School of Medicine, Nankai University, Tianjin 300192, China
| | - Jing-Rui Chen
- First Central Clinical College, Tianjin Medical University, Tianjin 300070, China
| | - Xiang-Yu Liu
- Tianjin First Central Hospital Clinic Institute, School of Medicine, Nankai University, Tianjin 300192, China
| | - Bin Zheng
- School of Medicine, Tianjin University, Tianjin 300072, China
| | - Zi-Lin Cui
- Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
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28
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Chen B, Chittò M, Tao S, Wagemans J, Lavigne R, Richards RG, Metsemakers WJ, Moriarty TF. Isolation and Antibiofilm Activity of Bacteriophages against Cutibacterium acnes from Patients with Periprosthetic Joint Infection. Viruses 2024; 16:1592. [PMID: 39459925 PMCID: PMC11512206 DOI: 10.3390/v16101592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2024] [Revised: 09/24/2024] [Accepted: 10/07/2024] [Indexed: 10/28/2024] Open
Abstract
BACKGROUND Infections following shoulder surgery, particularly periprosthetic joint infection (PJI), are challenging to treat. Cutibacterium acnes is the causative pathogen in 39% to 76% of these cases. This study explores the efficacy of bacteriophage therapy as an alternative to conventional antibiotics for treating such infections. METHODS Nine phages with lytic activity were isolated from the skin of humans using C. acnes ATCC 6919 as the indicator host. These phages were tested individually or in combination to assess host range and antibiofilm activity against clinical strains of C. acnes associated with PJIs. The phage cocktail was optimized for broad-spectrum activity and tested in vitro against biofilms formed on titanium discs to mimic the prosthetic environment. RESULTS The isolated phages displayed lytic activity against a range of C. acnes clinical isolates. The phage cocktail significantly reduced the bacterial load of C. acnes strains 183, 184, and GG2A, as compared with untreated controls (p < 0.05). Individual phages, particularly CaJIE7 and CaJIE3, also demonstrated significant reductions in bacterial load with respect to specific strains. Moreover, phages notably disrupted the biofilm structure and reduced biofilm biomass, confirming the potential of phage therapy in targeting biofilm-associated infections. CONCLUSIONS Our preclinical findings support the potential of phage therapy as a viable adjunct to traditional antibiotics for treating C. acnes infections in orthopedic device-related infections. The ability of phages to disrupt biofilms may be particularly beneficial for managing infections associated with prosthetic implants.
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Affiliation(s)
- Baixing Chen
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (B.C.)
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- AO Research Institute Davos, 7270 Davos, Switzerland
| | - Marco Chittò
- AO Research Institute Davos, 7270 Davos, Switzerland
| | - Siyuan Tao
- Laboratory for Biointerfaces, Empa, 9014 St. Gallen, Switzerland
| | - Jeroen Wagemans
- Laboratory of Gene Technology, KU Leuven, 3000 Leuven, Belgium
| | - Rob Lavigne
- Laboratory of Gene Technology, KU Leuven, 3000 Leuven, Belgium
| | | | - Willem-Jan Metsemakers
- Department of Trauma Surgery, University Hospitals Leuven, 3000 Leuven, Belgium; (B.C.)
- Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
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29
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Alonso-Menchén D, Marín-Arriaza M, Villamarín M, Fernández-Hidalgo N, López-Azor JC, Calderón-Parra J, Águila Fernández-Paniagua E, Hidalgo-Tenorio C, de Alarcón A, Goenaga-Sánchez MÁ, Rodríguez-Esteban MÁ, García Vázquez E, Grillo S, Bouza Santiago E, Muñoz P. Cutibacterium Species Valvular and Cardiac Device-Related Infective Endocarditis: Contemporary Data From the GAMES Prospective Cohort (2008-2023). Clin Infect Dis 2024; 79:663-671. [PMID: 38913722 DOI: 10.1093/cid/ciae334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 06/06/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Information on infective endocarditis (IE) caused by Cutibacterium spp. is limited and new Duke-International Society for Cardiovascular Infectious Diseases (ISCVID) criteria have not yet been properly assessed. We examined clinical characteristics, outcomes, and performance of diagnostic tests for Cutibacterium valvular and cardiac implantable electronic device-related IE (CIED-IE). METHODS Data corresponding to all episodes of Cutibacterium IE recorded from 2008 to 2023 in a prospective national cohort including 46 Spanish hospitals were examined. Possible IE cases were reassessed using the new criteria. The sensitivity of blood cultures, valvular and CIED cultures, and polymerase chain reaction of the 16S rRNA gene and sequencing (16SPCR) was evaluated. RESULTS Of 6692 episodes of IE, 67 (1%) were caused by Cutibacterium spp. with 85% affecting men. Of these, 50 were valve-related (45 prosthetic, 5 native) and 17 CIED-related. The new criteria identified 8 additional cases and reclassified 15 as definite IE. Intracardiac complications (abscess, pseudoaneurysm, perforation, or intracardiac fistula) occurred in 23 of 50 (46%) valvular IE episodes, leading to 18% mortality, and up to 40% mortality if surgery was indicated but could not be performed. All CIED-IE cases underwent device removal and no deaths were recorded. Positive diagnosis rates for blood cultures, valve/device cultures, and 16SPCR were 52%, 70%, and 82%, respectively. CONCLUSIONS Cutibacterium IE is a rare yet potentially life-threatening condition that warrants a high index of suspicion in men with endovascular prosthetic material. The new Duke-ISCVID criteria and molecular techniques are useful for its diagnosis. Considering a significant complication rate, cardiac surgery and removal of CIEDs play a key role in reducing mortality.
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Affiliation(s)
- David Alonso-Menchén
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Mercedes Marín-Arriaza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Miguel Villamarín
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Nuria Fernández-Hidalgo
- Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jorge Calderón-Parra
- Unidad de Enfermedades Infecciosas, Hospital Universitario Puerta de Hierro, Instituto de Investigación Sanitaria Puerta de Hierro - Segovia de Arana, Madrid, Spain
| | | | - Carmen Hidalgo-Tenorio
- Servicio de Medicina Interna, Hospital Universitario Virgen de las Nieves, Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Arístides de Alarcón
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, Spain
| | - Miguel Ángel Goenaga-Sánchez
- Servicio de Enfermedades Infecciosas, Hospital Universitario Donosti, Instituto de Investigación Sanitaria Biodonostia, San Sebastián, Spain
| | | | - Elisa García Vázquez
- Servicio de Medicina Interna-Infecciosas, Instituto Murciano de Investigación Biosanitaria, Hospital Clínico Universitario Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
| | - Sara Grillo
- Servei de Medicina Interna, Unitat de Malalties Infeccioses, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Emilio Bouza Santiago
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Patricia Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
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30
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Shafiuddin M, Prather GW, Huang WC, Anton JR, Martin AL, Sillart SB, Tang JZ, Vittori MR, Prinsen MJ, Ninneman JJ, Manithody C, Henderson JP, Aleem AW, Ilagan MXG, McCoy WH. Cutibacterium adaptation to life on humans provides a novel biomarker of C. acnes infections. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.18.613542. [PMID: 39345635 PMCID: PMC11429735 DOI: 10.1101/2024.09.18.613542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
The domestication of cattle provided Propionibacteriaceae the opportunity to adapt to human skin. These bacteria constitute a distinct genus ( Cutibacterium ), and a single species within that genus ( C. acnes ) dominates 25% of human skin. C. acnes protects humans from pathogen colonization, but it can also infect indwelling medical devices inserted through human skin. Proteins that help Cutibacteria live on our skin may also act as virulence factors during an opportunistic infection, like a shoulder periprosthetic joint infection (PJI). To better understand the evolution of this commensal and opportunistic pathogen, we sought to extensively characterize one of these proteins, RoxP. This secreted protein is only found in the Cutibacterium genus, helps C. acnes grow in oxic environments, and is required for C. acnes to colonize human skin. Structure-based sequence analysis of twenty-one RoxP orthologs (71-100% identity to C. acnes strain KPA171202 RoxP_1) revealed a high-degree of molecular surface conservation and helped identify a potential heme-binding interface. Biophysical evaluation of a subset of seven RoxP orthologs (71-100% identity) demonstrated that heme-binding is conserved. Computational modeling of these orthologs suggests that RoxP heme-binding is mediated by an invariant molecular surface composed of a surface-exposed tryptophan (W66), adjacent cationic pocket, and nearby potential heme axial ligands. Further, these orthologs were found to undergo heme-dependent oligomerization. To further probe the role of this protein in C. acnes biology, we developed four monoclonal anti-RoxP antibodies, assessed the binding of those antibodies to a subset of ten RoxP orthologs (71-100% identity), developed an anti-RoxP sandwich ELISA (sELISA) with sub-nanogram sensitivity, and adapted that sELISA to quantitate RoxP in human biofluids that can be infected by C. acnes (serum, synovial fluid, cerebrospinal fluid). This study expands our understanding of how an environmental bacterium evolved to live on humans, and the assays developed in this work can now be used to identify this organism when it gains access to sterile sites to cause opportunistic infections. Author Summary The longer humans live, the more they require internal "replacement parts," like prosthetic joints. Increased placement of these and other medical devices has increased their complications, which frequently are infections caused by microbes that live on humans. One of these microbes is Cutibacterium acnes , which dominates 25% of human skin. It appears that when humans domesticated cattle, a C. acnes ancestor adapted from living in cows to living on people. One of these adaptations was RoxP, a protein only found in Cutibacterium and carried by all C. acnes . Here, we describe our extensive characterization of RoxP. We found that distantly related RoxP conserve high stability at the low pH found on human skin. They also conserve the ability to bind heme, a source of iron used by microbes when they infect humans. As a part of this work, we developed tests that measure RoxP to identify C. acnes growth. In a clinic or hospital, these tests could allow a doctor to rapidly identify C. acnes infections, which would improve patient outcomes and lower healthcare costs. This work has helped us better understand how C. acnes adapted to live on humans and to identify C. acnes infections of medical devices.
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Balézeaux Q, Leroux A, Krug B, Rondelet B, Belhaj A. Early and severe aortic endograft infection after percutaneous coil embolization of type 2 endoleak: A case report. Int J Surg Case Rep 2024; 122:110140. [PMID: 39142184 PMCID: PMC11372614 DOI: 10.1016/j.ijscr.2024.110140] [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: 07/11/2024] [Revised: 07/31/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024] Open
Abstract
INTRODUCTION Endovascular aneurysm repair for abdominal aortic aneurysm is superior to open surgery regarding perioperative morbidity and mortality. Complications such as endoleaks represent a significant source of secondary intervention. Vascular graft infection is another serious complication found in 0.2 to 1 % of series. We hereby describe a case of a rapidly progressive aortic infection by Cutibacterium acnes following a percutaneous embolization procedure for a type II endoleak. CASE PRESENTATION A 75-year-old man presented with a fever along with lower back and buttock pain five days after embolization via direct percutaneous puncture for a type II endoleak. White blood cell scintigraphy and blood culture suggested the presence of aortitis, but the patient experienced notable spontaneous improvement in both clinical symptoms and biological markers. The patient underwent CT-angiography which revealed aneurysm rupture requiring urgent open surgery and initiation of antimicrobial therapy. Similarly to blood cultures, per-operative aortic wall tissue samples also revealed presence of Cutibacterium acnes. DISCUSSION Aortic endograft infection after embolization is an uncommon complication. The diagnosis is based on a combination of imaging, blood, and nuclear tests. Repeated CT-angiography may be helpful when infection occurs quickly after embolization. Staphylococcus and Streptococci are common pathogens implicated in these infections. CONCLUSIONS This is a case of an early and severe aortic endograft infection after percutaneous coil embolization of type 2 endoleak. Rupture occurred in less two weeks despite a slow-growing organism infection. The treatment includes endograft removal and antibacterial therapy. Caution is warranted when suspecting aortic endoprosthesis infection, necessitating close follow-up.
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Affiliation(s)
- Quentin Balézeaux
- Department of Cardio-Vascular, Thoracic Surgery and Lung Transplantation, CHU UcL Namur, UcLouvain, Yvoir, Belgium.
| | - Aurélie Leroux
- Department of Cardio-Vascular, Thoracic Surgery and Lung Transplantation, CHU UcL Namur, UcLouvain, Yvoir, Belgium
| | - Bruno Krug
- Department of Nuclear Medicine, CHU UCL Namur, Godinne Site, Université Catholique de Louvain, Belgium
| | - Benoit Rondelet
- Department of Cardio-Vascular, Thoracic Surgery and Lung Transplantation, CHU UcL Namur, UcLouvain, Yvoir, Belgium
| | - Asmae Belhaj
- Department of Cardio-Vascular, Thoracic Surgery and Lung Transplantation, CHU UcL Namur, UcLouvain, Yvoir, Belgium
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Tonotsuka H, Sugiyama H, Funasaki H, Yoshida M, Kato S, Tanaka K, Saito M. Chronological changes in the rate of surgical field contamination in the shoulder joint. J Orthop Sci 2024; 29:1220-1225. [PMID: 37838595 DOI: 10.1016/j.jos.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/04/2023] [Accepted: 09/28/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND In shoulder surgery, low-virulence bacteria such as Cutibacterium acnes and coagulase-negative staphylococci can cause postoperative infection. However, the degree of sterility during surgery after disinfection is not known, and the efficacy of double skin preparation for such bacteria is unclear. This study aimed to evaluate chronological changes in the surgical field contamination rate in the shoulder joint and to compare single and double skin preparation. METHODS In total, 126 shoulders in 121 patients undergoing shoulder surgery (64 men, 62 women; mean age 64 years) were enrolled. Patients were divided into two groups: single skin preparation, where the site was painted with 10% povidone iodine, and double skin preparation, where the site was treated with 1% chlorhexidine gluconate/83% isopropyl alcohol and painted 10% povidone iodine. Swab samples from the axillary and proximal areas in the surgical field were collected chronologically before starting surgery and at 30, 60, and 120 min after starting surgery (MAS). The contamination rate of each sample was compared and detected species were evaluated. RESULTS The contamination rate for the axillary area was 48.4%, 85.9%, 95.3%, and 97.1% in the single-preparation group and 32.3%, 72.6%, 87.1%, and 91.2% in the double-preparation group before starting surgery and 30, 60, and 120 MAS, respectively, and that the proximal area was 12.5%, 26.6%, 29.7%, and 35.3% in the single-preparation group and 16.1%, 19.4%, 27.4%, and 38.2% in the double-preparation group, respectively. Significant differences were not seen between the groups by area or time point. Most detected species were Cutibacterium acnes and coagulase-negative staphylococci. CONCLUSIONS The incidence of surgical field contamination in shoulder joint was high from immediately after starting surgery. In the axillary area, the contamination rates exceeded 70% from 30 MAS in both groups. Measures against infection should be instituted considering these findings when performing shoulder surgery.
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Affiliation(s)
- Hisahiro Tonotsuka
- Department of Orthopaedic Surgery, Kanagawa Rehabilitation Hospital, Japan; Department of Orthopaedic Surgery, The Jikei University School of Medicine, Japan.
| | - Hajime Sugiyama
- Department of Orthopaedic Surgery, Kanagawa Rehabilitation Hospital, Japan; Department of Orthopaedic Surgery, The Jikei University School of Medicine, Japan
| | - Hiroki Funasaki
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Japan
| | - Mamoru Yoshida
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Japan
| | - Soki Kato
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Japan
| | - Kota Tanaka
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Japan
| | - Mitsuru Saito
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Japan
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Madariaga MC, O'Malley NA, Groff H, Alben M, Papalia A, Fogel J, Thompson J, Apazidis A. Does hydrogen peroxide help mitigate the incidence of Cutibacterium acnes in cervical spine surgeries? NORTH AMERICAN SPINE SOCIETY JOURNAL 2024; 19:100514. [PMID: 39175928 PMCID: PMC11339044 DOI: 10.1016/j.xnsj.2024.100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/06/2024] [Accepted: 06/25/2024] [Indexed: 08/24/2024]
Abstract
Background Surgical site infection (SSI) is a common yet serious complication of cervical spine surgery. While initially thought to be clinically insignificant, Cutibacterium acnes (C. acnes) is an important cause of infection. The purpose of this study was to investigate the ability of a hydrogen peroxide (H2O2) application during standard presurgical skin preparation to reduce the burden of C. acnes in patients undergoing cervical spine surgery. Methods This was a retrospective review of prospectively collected data. Subjects were randomly assigned to either standard surgical preparation plus H2O2 (experimental) or without H2O2 (control). Prescrub, postscrub, and dermal cultures were obtained to assess the C. acnes burden after cultures on an aerobic and anaerobic growth medium were held for 21 days. Multivariate analysis was conducted to determine factors associated with presence of C. acnes. Outcome measures included the results of intraoperative cultures and the development of a SSI within 90 days postoperatively. Results Patients (n=86) undergoing elective 2- or 3-level fusion via anterior approach were included. Prior to application of the antiseptic solution, 65% (28/43) of the experimental cohort and 77% (33/43) of the control cohort had positive C. acnes cultures (p=.34). Following application of antiseptic solution, there were no differences in positive C. acnes culture rates between the experimental and control cohorts in the epidermal (30% vs. 28%, p=1.00) or dermal (40% vs. 42%, p=1.00) cultures. No differences in the rates of C. acnes eradication from preantiseptic to postantiseptic application occurred for epidermal (p=1.00) or dermal (p=1.00) skin layers. None of the factors were associated with positive C. acnes epidermal cultures on multivariable logistic regression analysis (p>.05). Conclusions While there is potential for H2O2 to reduce the positive culture rate of C. acnes in cervical spine patients, no difference was seen when compared to standard surgical skin preparation.
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Affiliation(s)
| | - Nicholas A. O'Malley
- Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, NY 11554
| | - Hannah Groff
- Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, NY 11554
| | - Matthew Alben
- State University at Buffalo, Department of Orthopedic Surgery, Buffalo, NY
| | - Aidan Papalia
- Geisnger Health, Department of Orthopedic Surgery, Danville, PA
| | - Joshua Fogel
- Department of Biostatistics, Nassau University Medical Center, East Meadow, NY 11554
| | - Jeffrey Thompson
- Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, NY 11554
| | - Alexios Apazidis
- Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, NY 11554
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Baroudi M, Daher M, Parks RD, Gregoryczyk JG, Balmaceno-Criss M, McDonald CL, Diebo BG, Daniels AH. Cutibacterium acnes in spine surgery: pathophysiology, diagnosis, and treatment. Spine J 2024; 24:1545-1552. [PMID: 38679079 DOI: 10.1016/j.spinee.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Cutibacterium acnes (C. acnes) previously named Propionibacterium acnes (P. acnes) has been increasingly recognized by spine surgeons as a cause of indolent postsurgical spinal infection. Patients infected with C. acnes may present with pseudarthrosis or nonspecific back pain. Currently, microbiological tissue cultures remain the gold standard in diagnosing C. acnes infection. Ongoing research into using genetic sequencing as a diagnostic method shows promising results and may be another future way of diagnosis. Optimized prophylaxis involves the use of targeted antibiotics, longer duration of antibiotic prophylaxis, antibacterial-coated spinal implants, and evidence-based sterile surgical techniques all of which decrease contamination. Antibiotics and implant replacement remain the mainstay of treatment, with longer durations of antibiotics proving to be more efficacious. Local guidelines must consider the surge of antimicrobial resistance worldwide when treating C. acnes.
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Affiliation(s)
- Makeen Baroudi
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Mohammad Daher
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Russell D Parks
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Jerzy George Gregoryczyk
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Mariah Balmaceno-Criss
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Christopher L McDonald
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Bassel G Diebo
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA
| | - Alan H Daniels
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, 1 Kettle Point Ave, Providence, RI 02914, USA.
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Sparling K, O'Haver JA. Acne Demystified: A Roadmap to Clear and Healthy Skin for Your Patients. Clin Pediatr (Phila) 2024; 63:1029-1037. [PMID: 38014501 DOI: 10.1177/00099228231210710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- Kennedy Sparling
- College of Medicine, The University of Arizona, Phoenix, AZ, USA
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Licht P, Dominelli N, Kleemann J, Pastore S, Müller ES, Haist M, Hartmann KS, Stege H, Bros M, Meissner M, Grabbe S, Heermann R, Mailänder V. The skin microbiome stratifies patients with cutaneous T cell lymphoma and determines event-free survival. NPJ Biofilms Microbiomes 2024; 10:74. [PMID: 39198450 PMCID: PMC11358159 DOI: 10.1038/s41522-024-00542-4] [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: 11/27/2023] [Accepted: 07/31/2024] [Indexed: 09/01/2024] Open
Abstract
Mycosis fungoides (MF) is the most common entity of Cutaneous T cell lymphomas (CTCL) and is characterized by the presence of clonal malignant T cells in the skin. The role of the skin microbiome for MF development and progression are currently poorly understood. Using shotgun metagenomic profiling, real-time qPCR, and T cell receptor sequencing, we compared lesional and nonlesional skin of 20 MF patients with early and advanced MF. Additionally, we isolated Staphylococcus aureus and other bacteria from MF skin for functional profiling and to study the S. aureus virulence factor spa. We identified a subgroup of MF patients with substantial dysbiosis on MF lesions and concomitant outgrowth of S. aureus on plaque-staged lesions, while the other MF patients had a balanced microbiome on lesional skin. Dysbiosis and S. aureus outgrowth were accompanied by ectopic levels of cutaneous antimicrobial peptides (AMPs), including adaptation of the plaque-derived S. aureus strain. Furthermore, the plaque-derived S. aureus strain showed a reduced susceptibility towards antibiotics and an upregulation of the virulence factor spa, which may activate the NF-κB pathway. Remarkably, patients with dysbiosis on MF lesions had a restricted T cell receptor repertoire and significantly lower event-free survival. Our study highlights the potential for microbiome-modulating treatments targeting S. aureus to prevent MF progression.
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Affiliation(s)
- Philipp Licht
- University Medical Centre Mainz, Department of Dermatology, Mainz, Germany.
| | - Nazzareno Dominelli
- Johannes Gutenberg-University, Institute of Molecular Physiology (imP), Biocenter II, Microbiology and Biotechnology, Mainz, Germany
| | - Johannes Kleemann
- University Hospital Frankfurt, Department of Dermatology, Venerology and Allergology, Frankfurt am Main, Germany
| | - Stefan Pastore
- University Medical Centre Mainz, Institute of Human Genetics, Mainz, Germany
- Johannes Gutenberg-University, Institute of Pharmaceutical and Biomedical Sciences, Mainz, Germany
| | - Elena-Sophia Müller
- Johannes Gutenberg-University, Institute of Molecular Physiology (imP), Biocenter II, Microbiology and Biotechnology, Mainz, Germany
| | - Maximilian Haist
- University Medical Centre Mainz, Department of Dermatology, Mainz, Germany
| | | | - Henner Stege
- University Medical Centre Mainz, Department of Dermatology, Mainz, Germany
| | - Matthias Bros
- University Medical Centre Mainz, Department of Dermatology, Mainz, Germany
| | - Markus Meissner
- University Hospital Frankfurt, Department of Dermatology, Venerology and Allergology, Frankfurt am Main, Germany
| | - Stephan Grabbe
- University Medical Centre Mainz, Department of Dermatology, Mainz, Germany
| | - Ralf Heermann
- Johannes Gutenberg-University, Institute of Molecular Physiology (imP), Biocenter II, Microbiology and Biotechnology, Mainz, Germany
| | - Volker Mailänder
- University Medical Centre Mainz, Department of Dermatology, Mainz, Germany.
- Max Planck Institute for Polymer Research, Mainz, Germany.
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Liu P, Song Y, Chen Z, Zhang Z, Li Z. Efficacy of antibiotic prophylaxis for reducing capsular contracture in prosthesis-based breast surgery: a systemic review and meta-analysis. Updates Surg 2024; 76:1183-1194. [PMID: 38396193 DOI: 10.1007/s13304-024-01767-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Antibiotics Prophylaxis to prevent capsular contracture in prosthesis-based breast surgery is common in clinical practice. However, there is currently a dearth of high-quality evidence concerning the effectiveness of antibiotic usage in this field. To identify all pertinent studies prior to January 2023, a comprehensive literature search was conducted in the PubMed, Embase, Web of Science, Cochrane Library, and Medline databases. The extracted data was then subjected to meta-analysis. Fourteen studies were retained in the analysis. According to the results, perioperative antibiotic prophylaxis did not reduce the risk of capsular contracture (RR 1.15, 95% CI 0.82-1.59, p = 0.55) or surgical-site infection (RD 0.01, 95% CI - 0.01 to 0.03, p = 0.59) compared to nonantibiotic prophylaxis. There was no statistically significant difference between extended antibiotic prophylaxis and perioperative antibiotic prophylaxis in terms of preventing capsular contracture, whether calculated by patient numbers (RD 0.01, 95% CI - 0.01 to 0.02, p = 0.87) or by total procedures (RD 0.00, 95% CI - 0.00 to 0.01, p = 0.88), or controlling surgical-site infection (RR 1.05, 95% CI 0.77-1.44, p = 0.27). Additionally, topical antibiotic irrigation did not decrease the risk of infection (RR 0.61, 95% CI 0.34-1.08, p = 0.29) and capsular contracture, regardless of patient number (RR 0.41, 95% CI 0.27-0.63, p = 0.18) or total number of procedures (RR 1.29, 95% CI 0.73-2.28, p < 0.01). Current evidence revealed that both systemic and topical antibiotic prophylaxis may not provide benefits in preventing capsular contracture in prosthesis-based breast surgery. When the occurrence of surgical-site infections is minimized to the greatest extent, the administration of additional antibiotics for reducing capsular contracture should be carefully and judiciously considered.
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Affiliation(s)
- Pengcheng Liu
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuting Song
- Department of Orthopedic Surgery and Orthopedic Research Institute, Laboratory of Stem Cell and Tissue Engineering, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhixing Chen
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhenyu Zhang
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhengyong Li
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Min TT, Choowongkomon K, Htoo HH, Nonejuie P, Haltrich D, Yamabhai M. Anti-CAMP1 IgG promotes macrophage phagocytosis of Cutibacterium acnes type II. Microbiol Res 2024; 285:127749. [PMID: 38761490 DOI: 10.1016/j.micres.2024.127749] [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: 03/20/2024] [Revised: 04/28/2024] [Accepted: 05/03/2024] [Indexed: 05/20/2024]
Abstract
Among 5 types of the Christie-Atkins-Munch-Petersen factor (CAMP) of Cutibacterium acnes, CAMP1 is highly expressed in phylotype II as well as IB, and thought to be a virulence factor of opportunistic but fatal blood, soft tissue, and implant-related infections. The target of a human single-chain variable antibody fragment (scFv), recently isolated from a phage display library, has been identified as CAMP1 of phylotype II, using immunoprecipitation followed by mass spectrometry, phage display peptide biopanning, 3D-modelling, and ELISA. The IgG1 format of the antibody could enhance phagocytosis of C. acnes DMST 14916 by THP-1 human monocytes. Our results suggest that the antibody-dependent phagocytosis process is mediated by the caveolae membrane system and involves the induction of IL-1β. This is the first report on the study of a human antibody against CAMP1 of C. acnes phylotype II, of which a potential use as therapeutic antibody against virulence C. acnes infection is postulated.
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Affiliation(s)
- Thae Thae Min
- Molecular Biotechnology Laboratory, School of Biotechnology, Institute of Agricultural Technology, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand
| | - Kiattawee Choowongkomon
- Department of Biochemistry, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
| | - Htut Htut Htoo
- Institute of Molecular Biosciences, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
| | - Poochit Nonejuie
- Institute of Molecular Biosciences, Mahidol University, Salaya, Nakhon Pathom 73170, Thailand
| | - Dietmar Haltrich
- Department of Food Sciences and Technology, University of Natural Resources and Life Sciences, Vienna 1190, Austria
| | - Montarop Yamabhai
- Molecular Biotechnology Laboratory, School of Biotechnology, Institute of Agricultural Technology, Suranaree University of Technology, Nakhon Ratchasima 30000, Thailand.
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Varin-Simon J, Colin M, Velard F, Tang-Fichaux M, Ohl X, Mongaret C, Gangloff SC, Reffuveille F. Cutibacterium acnes biofilm formation is influenced by bone microenvironment, implant surfaces and bacterial internalization. BMC Microbiol 2024; 24:270. [PMID: 39033146 PMCID: PMC11264938 DOI: 10.1186/s12866-024-03422-1] [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: 12/19/2023] [Accepted: 07/10/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND The bacterial persistence, responsible for therapeutic failures, can arise from the biofilm formation, which possesses a high tolerance to antibiotics. This threat often occurs when a bone and joint infection is diagnosed after a prosthesis implantation. Understanding the biofilm mechanism is pivotal to enhance prosthesis joint infection (PJI) treatment and prevention. However, little is known on the characteristics of Cutibacterium acnes biofilm formation, whereas this species is frequently involved in prosthesis infections. METHODS In this study, we compared the biofilm formation of C. acnes PJI-related strains and non-PJI-related strains on plastic support and textured titanium alloy by (i) counting adherent and viable bacteria, (ii) confocal scanning electronic microscopy observations after biofilm matrix labeling and (iii) RT-qPCR experiments. RESULTS We highlighted material- and strain-dependent modifications of C. acnes biofilm. Non-PJI-related strains formed aggregates on both types of support but with different matrix compositions. While the proportion of polysaccharides signal was higher on plastic, the proportions of polysaccharides and proteins signals were more similar on titanium. The changes in biofilm composition for PJI-related strains was less noticeable. For all tested strains, biofilm formation-related genes were more expressed in biofilm formed on plastic that one formed on titanium. Moreover, the impact of C. acnes internalization in osteoblasts prior to biofilm development was also investigated. After internalization, one of the non-PJI-related strains biofilm characteristics were affected: (i) a lower quantity of adhered bacteria (80.3-fold decrease), (ii) an increase of polysaccharides signal in biofilm and (iii) an activation of biofilm gene expressions on textured titanium disk. CONCLUSION Taken together, these results evidenced the versatility of C. acnes biofilm, depending on the support used, the bone environment and the strain.
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Affiliation(s)
- Jennifer Varin-Simon
- Université de Reims Champagne-Ardenne, BIOS, Reims, France.
- Université de Reims Champagne-Ardenne, UFR Pharmacie, Reims, France.
| | - Marius Colin
- Université de Reims Champagne-Ardenne, BIOS, Reims, France
- Université de Reims Champagne-Ardenne, UFR Pharmacie, Reims, France
| | - Frédéric Velard
- Université de Reims Champagne-Ardenne, BIOS, Reims, France
- Université de Reims Champagne-Ardenne, UFR Odontologie, Reims, France
| | | | - Xavier Ohl
- Université de Reims Champagne-Ardenne, BIOS, Reims, France
- CHU Reims, Service d'Orthopédie et Traumatologie, Reims, France
| | - Céline Mongaret
- Université de Reims Champagne-Ardenne, BIOS, Reims, France
- Université de Reims Champagne-Ardenne, UFR Pharmacie, Reims, France
- CHU Reims, Service Pharmacie, Reims, France
| | - Sophie C Gangloff
- Université de Reims Champagne-Ardenne, BIOS, Reims, France
- Université de Reims Champagne-Ardenne, UFR Pharmacie, Reims, France
| | - Fany Reffuveille
- Université de Reims Champagne-Ardenne, BIOS, Reims, France
- Université de Reims Champagne-Ardenne, UFR Pharmacie, Reims, France
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Yoshida M, Hayashi S, Haraguchi T, Ito M, Hatanaka Y, Yoshii M, Tatsuoka H, Tanaka S, Nagao T. Antimicrobial Activity of Positively Charged Oligopeptides with Theoretical High α-Helix Content against Cutibacterium acnes. Int J Mol Sci 2024; 25:7445. [PMID: 39000551 PMCID: PMC11242407 DOI: 10.3390/ijms25137445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/01/2024] [Accepted: 07/04/2024] [Indexed: 07/16/2024] Open
Abstract
Cutibacterium acnes is abundant and commonly exists as a superficial bacteria on human skin. Recently, the resistance of C. acnes to antimicrobial agents has become a serious concern, necessitating the development of alternative pharmaceutical products with antimicrobial activity against C. acnes. To address this need, we evaluated the antimicrobial activity of CKR-13-a mutant oligopeptide of FK-13 with increased net charge and theoretical α-helical content-against C. acnes in modified Gifu Anaerobic Medium broth by determining the minimum inhibitory concentration (MIC). CKR-13 exerted greater antimicrobial activity against C. acnes than FK-13 in the broth at pH 7.0. The antimicrobial activity of CKR-13 with RXM against C. albicans was pH-dependent. The ionization of CKR-13 and pH-dependent growth delay of C. albicans was suggested to be associated with the increase in CKR-13 antimicrobial activity.
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Affiliation(s)
- Miyako Yoshida
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Saki Hayashi
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Tamami Haraguchi
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Momoka Ito
- Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Mukogawa Women’s University, 11-68 Koshien 9-Bancho, Nishinomiya City 663-8179, Hyogo, Japan; (S.H.); (T.H.); (M.I.)
| | - Yoshiro Hatanaka
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Miki Yoshii
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Hiroaki Tatsuoka
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Shigemitsu Tanaka
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
| | - Toshihiro Nagao
- Osaka Research Institute of Industrial Science and Technology, 1-6-50 Morinomiya, Joto-ku, Osaka City 536-8553, Osaka, Japan; (Y.H.); (M.Y.); (H.T.); (S.T.); (T.N.)
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Bjerg CSB, Poehlein A, Bömeke M, Himmelbach A, Schramm A, Brüggemann H. Increased biofilm formation in dual-strain compared to single-strain communities of Cutibacterium acnes. Sci Rep 2024; 14:14547. [PMID: 38914744 PMCID: PMC11196685 DOI: 10.1038/s41598-024-65348-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024] Open
Abstract
Cutibacterium acnes is a known opportunistic pathogen in orthopedic implant-associated infections (OIAIs). The species of C. acnes comprises distinct phylotypes. Previous studies suggested that C. acnes can cause single- as well as multi-typic infections, i.e. infections caused by multiple strains of different phylotypes. However, it is not known if different C. acnes phylotypes are organized in a complex biofilm community, which could constitute a multicellular strategy to increase biofilm strength and persistency. Here, the interactions of two C. acnes strains belonging to phylotypes IB and II were determined in co-culture experiments. No adverse interactions between the strains were observed in liquid culture or on agar plates; instead, biofilm formation in both microtiter plates and on titanium discs was significantly increased when combining both strains. Fluorescence in situ hybridization showed that both strains co-occurred throughout the biofilm. Transcriptome analyses revealed strain-specific alterations of gene expression in biofilm-embedded cells compared to planktonic growth, in particular affecting genes involved in carbon and amino acid metabolism. Overall, our results provide first insights into the nature of dual-type biofilms of C. acnes, suggesting that strains belonging to different phylotypes can form biofilms together with additive effects. The findings might influence the perception of C. acnes OIAIs in terms of diagnosis and treatment.
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Affiliation(s)
- Cecilie Scavenius Brønnum Bjerg
- Department of Biomedicine, Faculty of Health, Aarhus University, Aarhus, Denmark
- Department of Biology, Section for Microbiology, Aarhus University, Aarhus, Denmark
| | - Anja Poehlein
- Department of Genomic and Applied Microbiology, Institute of Microbiology and Genetics, University of Göttingen, Göttingen, Germany
| | - Mechthild Bömeke
- Department of Genomic and Applied Microbiology, Institute of Microbiology and Genetics, University of Göttingen, Göttingen, Germany
| | - Axel Himmelbach
- Leibniz Institute of Plant Genetics and Crop Plant Research (IPK), Gatersleben, Germany
| | - Andreas Schramm
- Department of Biology, Section for Microbiology, Aarhus University, Aarhus, Denmark
| | - Holger Brüggemann
- Department of Biomedicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
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Roudeau A, Corvec S, Heym B, d'Epenoux LR, Lidove O, Zeller V. Unusual Cutibacterium acnes splenic abscess with bacteremia in an immunocompetent man: phylotyping and clonal complex analysis. BMC Infect Dis 2024; 24:601. [PMID: 38898385 PMCID: PMC11186249 DOI: 10.1186/s12879-024-09467-x] [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: 01/04/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Cutibacterium acnes is an anaerobic bacterium mostly implicated in cutaneous and body-implant infections. Splenic abscess is a rare entity and C. acnes abscesses have only exceptionally been reported. We describe a spontaneous splenic C. acnes abscess in an immunocompetent man with no predisposing factors or identified portal of entry. His isolates were subjected to single-locus sequence typing (SLST) to explore their genetic relatedness and better understand this rare infection. CASE PRESENTATION A splenic abscess was diagnosed on a computed-tomography scan in a 74-year-old man with chronic abdominal pain. No risk factor was identified. Abscess-drained pus and post-drainage blood cultures grew C. acnes. SLST of abscess and blood isolates showed that they belonged to the same C. acnes SLST type C1 found in normal skin and rarely in inflammatory skin disease. Specific virulence factors could not be identified. CONCLUSION C. acnes abscesses are extremely rare and can develop in immunocompetent patients without an identifiable portal of entry. Molecular typing of clinical isolates can help confirm infection (versus contamination) and enables genetic background comparisons. Further research is needed to understand C. acnes tropism and virulence.
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Affiliation(s)
- Angèle Roudeau
- Department of Internal Medicine and Infectious Diseases, Groupe Hospitalier Diaconesses- Croix Saint-Simon, 125, rue d'Avron, Paris, 75020, France
| | - Stéphane Corvec
- Service de Bactériologie et des Contrôles Microbiologiques, CHU Nantes, Université de Nantes, INSERM, INCIT U1302, Nantes, France
| | - Beate Heym
- Laboratoire des Centres de Santé et Hôpitaux d'Île-de-France, Groupe Hospitalier Diaconesses- Croix Saint-Simon, 125, rue d'Avron, Paris, France
| | - Louise Ruffier d'Epenoux
- Service de Bactériologie et des Contrôles Microbiologiques, CHU Nantes, Université de Nantes, INSERM, INCIT U1302, Nantes, France
| | - Olivier Lidove
- Department of Internal Medicine and Infectious Diseases, Groupe Hospitalier Diaconesses- Croix Saint-Simon, 125, rue d'Avron, Paris, 75020, France
| | - Valérie Zeller
- Department of Internal Medicine and Infectious Diseases, Groupe Hospitalier Diaconesses- Croix Saint-Simon, 125, rue d'Avron, Paris, 75020, France.
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Zhang M, Jia J, Deng L, Cao Z, Hu X, Lei S, Zhang G, Zhu D, Duan Y, Kang X. Risk factors associated with low-grade virulent infection in intervertebral disc degeneration: a systematic review and meta-analysis. Spine J 2024; 24:1034-1045. [PMID: 38365007 DOI: 10.1016/j.spinee.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/26/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND An increasing number of research indicates an association between low-grade bacterial infections, particularly those caused by Propionibacterium acnes (P. acnes), and the development of intervertebral disc degeneration (IDD). However, no previous meta-analysis has systematically assessed the risk factors for low-grade bacterial infections that cause IDD. PURPOSE This study reviewed the literature to evaluate the risk factors associated with low-grade bacterial infection in patients with IDD. STUDY DESIGN Systematic review and meta-analysis. METHODS The systematic literature review was conducted using the PubMed, Web of Science, Embase, and Cochrane Library databases. Eligible articles explicitly identified the risk factors for low-grade bacterial infections in IDD patients. Patient demographics and total bacterial infection rates were extracted from each study. Meta-analysis was performed using random- or fixed-effects models, with statistical analyses conducted using Review Manager (RevMan) 5.4 software.aut. RESULTS Thirty-three studies involving 4,109 patients were included in the meta-analysis. The overall pooled low-grade bacterial infection rate was 30% (range, 24%-37%), with P. acnes accounting for 25% (range, 19%-31%). P. acnes constituted 66.7% of bacteria-positive discs. Fourteen risk factors were identified, of which 8 were quantitatively explored. Strong evidence supported male sex (odds ratio [OR] = 2.15; 95% confidence interval [CI]=1.65-2.79; p<.00001) and Modic changes (MCs) (OR=3.59; 95% CI=1.68-7.76; p=.0009); moderate evidence of sciatica (OR=2.31; 95% CI=1.33-4.00; p=.003) and younger age (OR=-3.47; 95% CI=-6.42 to -0.53; p=.02). No evidence supported previous disc surgery, MC type, Pfirrmann grade, smoking, or diabetes being risk factors for low-grade bacterial infections in patients with IDD. CONCLUSIONS Current evidence highlights a significant association between IDD and low-grade bacterial infections, predominantly P. acnes being the most common causative agent. Risk factors associated with low-grade bacterial infections in IDD include male sex, MCs, sciatica, and younger age.
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Affiliation(s)
- Mingtao Zhang
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
| | - Jingwen Jia
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China
| | - Liangna Deng
- Department of Radiology, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730000, Gansu, China
| | - Zhenyu Cao
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China
| | - Xuchang Hu
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China
| | - Shuanhu Lei
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China
| | - Guangzhi Zhang
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China
| | - Daxue Zhu
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China
| | - Yanni Duan
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China
| | - Xuewen Kang
- Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou 730000, Gansu, China; Orthopaedics Key Laboratory of Gansu Province, No. 82 Cuiyingmen, Chengguan District, Lanzhou, Gansu, 730000, China.
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Longo UG, Lalli A, Bandini B, Angeletti S, Lustig S, Budhiparama NC. The influence of gut microbiome on periprosthetic joint infections: State-of-the art. J ISAKOS 2024; 9:353-361. [PMID: 38272392 DOI: 10.1016/j.jisako.2024.01.011] [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: 05/26/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Early periprosthetic joint infection constitutes one of the most frightening complications of joint replacement. Recently, some evidence has highlighted the potential link between dysregulation of the gut microbiota and degenerative diseases of joints. It has been hypothesized that microbiome dysbiosis may increase the risk of periprosthetic joint infection by facilitating bacterial translocation from these sites to the bloodstream or by impairing local or systemic immune responses. Although the processes tying the gut microbiome to infection susceptibility are still unknown, new research suggests that the presurgical gut microbiota-a previously unconsidered component-may influence the patient's ability to resist infection. Exploring the potential impact of the microbiome on periprosthetic joint infections may therefore bring new insights into the pathogenesis and therapy of these disorders. For a successful therapy, a proper surgical procedure in conjunction with an antibacterial concept is essential. As per the surgical approach, different treatment strategies include surgical irrigation, debridement, antibiotic therapy, and implant retention with or without polyethylene exchange. Other alternatives could be one-stage or two-stage revisions surgery. Interventions that either directly target gut microbes as well as interventions that modify the composition and/or function of the commensal microbes represent an innovative and potentially successful field to be explored. In recent times, innovative therapeutic methods have arisen in the realm of microbiome restoration and the management of gut-related ailments. These progressive approaches offer fresh perspectives on tackling intricate microbial imbalances in the gastrointestinal tract. These emerging therapies signify a shift towards more precise and individualized approaches to microbiome restoration and the management of gut-related disorders. Once a more advanced knowledge of the pathways linking the gut microbiota to musculoskeletal tissues is gained, relevant microbiome-based therapies can be developed. If dysbiosis is proven to be a significant contributor, developing treatments for dysbiosis may represent a new frontier in the prevention of periprosthetic joint infections.
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Affiliation(s)
- Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Alberto Lalli
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
| | - Benedetta Bandini
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
| | - Silvia Angeletti
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy.
| | - Sebastien Lustig
- Orthopaedic Department, Lyon North University Hospital, Hôpital de La Croix Rousse, Hospices Civils de Lyon, 103 Grande Rue de la Croix Rousse, 69004 Lyon, France.
| | - Nicolaas Cyrillus Budhiparama
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Unversitas Airlangga, Jl. Mayjend. Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; Department of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
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Kaplan JB, Cywes-Bentley C, Pier GB, Yakandawala N, Sailer M, Edwards MS, Kridin K. Poly- β-(1→6)- N-acetyl-D-glucosamine mediates surface attachment, biofilm formation, and biocide resistance in Cutibacterium acnes. Front Microbiol 2024; 15:1386017. [PMID: 38751716 PMCID: PMC11094747 DOI: 10.3389/fmicb.2024.1386017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
Background The commensal skin bacterium Cutibacterium acnes plays a role in the pathogenesis of acne vulgaris and also causes opportunistic infections of implanted medical devices due to its ability to form biofilms on biomaterial surfaces. Poly-β-(1→6)-N-acetyl-D-glucosamine (PNAG) is an extracellular polysaccharide that mediates biofilm formation and biocide resistance in a wide range of bacterial pathogens. The objective of this study was to determine whether C. acnes produces PNAG, and whether PNAG contributes to C. acnes biofilm formation and biocide resistance in vitro. Methods PNAG was detected on the surface of C. acnes cells by fluorescence confocal microscopy using the antigen-specific human IgG1 monoclonal antibody F598. PNAG was detected in C. acnes biofilms by measuring the ability of the PNAG-specific glycosidase dispersin B to inhibit biofilm formation and sensitize biofilms to biocide killing. Results Monoclonal antibody F598 bound to the surface of C. acnes cells. Dispersin B inhibited attachment of C. acnes cells to polystyrene rods, inhibited biofilm formation by C. acnes in glass and polypropylene tubes, and sensitized C. acnes biofilms to killing by benzoyl peroxide and tetracycline. Conclusion C. acnes produces PNAG, and PNAG contributes to C. acnes biofilm formation and biocide resistance in vitro. PNAG may play a role in C. acnes skin colonization, biocide resistance, and virulence in vivo.
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Affiliation(s)
- Jeffrey B. Kaplan
- Department of Biology, American University, Washington, DC, United States
- Laboratory for Skin Research, Institute for Medical Research, Galilee Medical Center, Nahariya, Israel
| | - Colette Cywes-Bentley
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Gerald B. Pier
- Division of Infectious Diseases, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | | | | | | | - Khalaf Kridin
- Laboratory for Skin Research, Institute for Medical Research, Galilee Medical Center, Nahariya, Israel
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Jiao Q, Zhi L, You B, Wang G, Wu N, Jia Y. Skin homeostasis: Mechanism and influencing factors. J Cosmet Dermatol 2024; 23:1518-1526. [PMID: 38409936 DOI: 10.1111/jocd.16155] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 12/08/2023] [Accepted: 12/17/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND The skin is the largest organ in the human body, not only resisting the invasion of harmful substances, but also preventing the loss of moisture and nutrients. Maintaining skin homeostasis is a prerequisite for the proper functioning of the body. Any damage to the skin can lead to a decrease in local homeostasis, such as ultraviolet radiation, seasonal changes, and air pollution, which can damage the skin tissue and affect the function of the skin barrier. OBJECTIVE This article reviews the maintenance mechanism and influencing factors of skin homeostasis and the symptoms of homeostasis imbalance. METHODS We searched for articles published between 1990 and 2022 in English and Chinese using PubMed, Web of Science, CNKI, and other databases in the subject area of dermatology, using the following search terms in various combinations: "skin homeostasis," "skin barrier," and "unstable skin." Based on our results, we further refined our search criteria to include a series of common skin problems caused by the destruction of skin homeostasis and its treatments. Limitations include the lack of research on dermatological and cosmetic problems triggered by the disruption of skin homeostasis. RESULTS This study describes the neuroendocrine-immune system, skin barrier structure, and skin metabolic system that maintain skin homeostasis. In addition, we discuss several common symptoms that occur when skin homeostasis is out of balance, such as dryness, redness, acne, sensitivity, and aging, and explain the mechanism of these symptoms. CONCLUSION This article provides an update and review for students and practitioners, and provides a theoretical basis for the development of skin care products for the maintenance and repair of skin homeostasis.
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Affiliation(s)
- Qian Jiao
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China
| | - Leilei Zhi
- R&D Center, PeiLai Group Co., Ltd, Shanghai, China
| | - Bing You
- R&D Center, PeiLai Group Co., Ltd, Shanghai, China
| | | | - Nan Wu
- R&D Center, PeiLai Group Co., Ltd, Shanghai, China
| | - Yan Jia
- Key Laboratory of Cosmetic of China National Light Industry, College of Chemistry and Materials Engineering, Beijing Technology and Business University, Beijing, China
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Lin Q, Cai B, Ke R, Chen L, Ni X, Liu H, Lin X, Wang B, Shan X. Integrative bioinformatics and experimental validation of hub genetic markers in acne vulgaris: Toward personalized diagnostic and therapeutic strategies. J Cosmet Dermatol 2024; 23:1777-1799. [PMID: 38268224 DOI: 10.1111/jocd.16152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/10/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Acne vulgaris is a widespread chronic inflammatory dermatological condition. The precise molecular and genetic mechanisms of its pathogenesis remain incompletely understood. This research synthesizes existing databases, targeting a comprehensive exploration of core genetic markers. METHODS Gene expression datasets (GSE6475, GSE108110, and GSE53795) were retrieved from the GEO. Differentially expressed genes (DEGs) were identified using the limma package. Enrichment analyses were conducted using GSVA for pathway assessment and clusterProfiler for GO and KEGG analyses. PPI networks and immune cell infiltration were analyzed using the STRING database and ssGSEA, respectively. We investigated the correlation between hub gene biomarkers and immune cell infiltration using Spearman's rank analysis. ROC curve analysis validated the hub genes' diagnostic accuracy. miRNet, TarBase v8.0, and ChEA3 identified miRNA/transcription factor-gene interactions, while DrugBank delineated drug-gene interactions. Experiments utilized HaCaT cells stimulated with Propionibacterium acnes, treated with retinoic acid and methotrexate, and evaluated using RT-qPCR, ELISA, western blot, lentiviral transduction, CCK-8, wound-healing, and transwell assays. RESULTS There were 104 genes with consistent differences across the three datasets of paired acne and normal skin. Functional analyses emphasized the significant enrichment of these DEGs in immune-related pathways. PPI network analysis pinpointed hub genes PTPRC, CXCL8, ITGB2, and MMP9 as central players in acne pathogenesis. Elevated levels of specific immune cell infiltration in acne lesions corroborated the inflammatory nature of the disease. ROC curve analysis identified the acne diagnostic potential of four hub genes. Key miRNAs, particularly hsa-mir-124-3p, and central transcription factors like TFEC were noted as significant regulators. In vitro validation using HaCaT cells confirmed the upregulation of hub genes following Propionibacterium acnes exposure, while CXCL8 knockdown reduced pro-inflammatory cytokines, cell proliferation, and migration. DrugBank insights led to the exploration of retinoic acid and methotrexate, both of which mitigated gene expression upsurge and inflammatory mediator secretion. CONCLUSION This comprehensive study elucidated pivotal genes associated with acne pathogenesis, notably PTPRC, CXCL8, ITGB2, and MMP9. The findings underscore potential biomarkers, therapeutic targets, and the therapeutic potential of agents like retinoic acid and methotrexate. The congruence between bioinformatics and experimental validations suggests promising avenues for personalized acne treatments.
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Affiliation(s)
- Qian Lin
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Key Laboratory of Translational Research in Cancer and Neurodegenerative Diseases, Institute for Translational Medicine, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian, China
| | - Beichen Cai
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Key Laboratory of Translational Research in Cancer and Neurodegenerative Diseases, Institute for Translational Medicine, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian, China
| | - Ruonan Ke
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou, Fujian, China
| | - Lu Chen
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Xuejun Ni
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Hekun Liu
- Fujian Key Laboratory of Translational Research in Cancer and Neurodegenerative Diseases, Institute for Translational Medicine, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian, China
| | - Xinjian Lin
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou, Fujian, China
| | - Biao Wang
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
- Fujian Key Laboratory of Translational Research in Cancer and Neurodegenerative Diseases, Institute for Translational Medicine, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, Fujian, China
| | - Xiuying Shan
- Department of Plastic Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
- Department of Plastic Surgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
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Klott J, Brolin TJ. Diagnostic Evaluation of Prosthetic Joint Infections of the Shoulder: What Does the Literature Say? Orthop Clin North Am 2024; 55:257-264. [PMID: 38403371 DOI: 10.1016/j.ocl.2023.09.006] [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: 02/27/2024]
Abstract
The total number of patients with a total shoulder arthroplasty (TSA) is increasing, and the number of patients experiencing a (TSA) prosthetic joint infection (PJI) also will increase. It is important that physicians know how to identify signs of infection, know the common pathogens, and know how to work up a shoulder PJI. This publication reviewed the current literature about presenting signs and symptoms, common shoulder pathogens and how they differ from total knee and hip pathogens, and what images, tests, and procedures can aid in identification of infection.
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Affiliation(s)
- Jeffrey Klott
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center- Campbell Clinic, 1211 Union Avenue, Suite 520, Memphis, TN 38104, USA
| | - Tyler J Brolin
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center- Campbell Clinic, 1211 Union Avenue, Suite 520, Memphis, TN 38104, USA.
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Torrens C, Bellosillo B, Gibert J, Suárez-López A, Santana F, Alier A. Are Cutibacterium acnes delivered from skin to deep tissues in primary reverse shoulder arthroplasty? A prospective study. Arch Orthop Trauma Surg 2024; 144:635-640. [PMID: 37994944 DOI: 10.1007/s00402-023-05125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/27/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION The objective of this study is to determine whether the deep tissues are inoculated during surgery with the Cutibacterium acnes still present in the skin after the surgical preparation in reverse shoulder arthroplasties. MATERIALS AND METHODS Prospective study including patients undergoing surgery with reverse shoulder arthroplasty. All the patients received preoperative antibiotic prophylaxis with cefazolin (2 g IV) and the skin was prepared with 2% chlorhexidine gluconate and 70% isopropyl alcohol. From all the patients, 9 cultures were obtained after the antibiotic was administrated and the skin surgically prepared. The cultures were sent to isolate C. acnes. DNA was extracted from the C. acnes isolated colonies. Isolate nucleotide distances were calculated using the Genome-based distance matrix calculator from the Enveomics collection toolbox. RESULTS The study included 90 patients. C. acnes was isolated in 24 patients (26.6%) with a total of 61 positive cultures. There were 12 phylotype II, 27 IB and 22 IA. In 9 patients, C. acnes was present in both skin and deep tissues, and they constituted the sample to be studied by means of genomic analysis. In 7 out of the 9 patients, deep tissue samples clustered closer to at least one of its corresponding skin isolates when compared to the other independent bacterial ones. CONCLUSIONS The C. acnes present in the skin at the beginning of the surgery are the same as those found in the deep tissues at the end of the surgery. This result strengthens the possibility that the C. acnes is delivered from the skin to the deep tissues.
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Affiliation(s)
- Carlos Torrens
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain.
| | - Beatriz Bellosillo
- Pathology Department, Hospital del Mar, Barcelona, Spain
- Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Joan Gibert
- Pathology Department, Hospital del Mar, Barcelona, Spain
- Cancer Research Program, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Amaya Suárez-López
- Microbiology Service, Laboratori de Referència de Catalunya, Hospital del Mar, Barcelona, Spain
| | - Fernando Santana
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
| | - Albert Alier
- Department of Orthopedics, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25-29, 08003, Barcelona, Spain
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50
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Otto-Lambertz C, Yagdiran A, Boschert AL, Eysel P, Walker SV. Detection of Cutibacterium (Propionibacterium) acnes in orthopaedic surgery: serious problem or contamination? INTERNATIONAL ORTHOPAEDICS 2024; 48:337-344. [PMID: 37730929 PMCID: PMC10799792 DOI: 10.1007/s00264-023-05981-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Bone and joint infections are an important and increasing problem. Whether intraoperatively detected bacteria should be considered relevant or not is often difficult to assess. This retrospective cohort study analyzes the relevance of C. acnes cultured from deep intraoperative specimens. METHODS All deep tissue samples collected intraoperatively between 2015 and 2020 from a quartiary care provider were evaluated for detection of C. acnes and its therapeutical consequences. Infection rates were determined according to a standardized definition and protocol and analyzed in dependence of patient's demographic data (age and gender), operative parameters (type of surgery, body region/location of surgery, and impression of the surgeon), and initiated therapy. RESULTS In 270 cases of more than 8500 samples, C. acnes was detected. In 30%, the detection was considered an infection. The number of samples taken and tested positive for C. acnes correlated significantly with its classification as a cause of infection. If more than one sample of the patient was positive, the detection was significantly more likely to be treated as infection (p < 0.001). In 76% of cases, a consultation to the infectious diseases (ID) department took place regarding the classification of the pathogen detection and the therapy to be carried out. Almost all of the tested isolates demonstrated the wild-type susceptibility for penicillin and clindamycin. CONCLUSION Intraoperative detection of skin-colonizing bacteria such as C. acnes is not always synonymous with infection. In particular, if other examination results contradict an infection (pathological sample without evidence of an infectious event, detection of malignant cells, etc.), the situation must be considered in a very differentiated manner. Interdisciplinary boards, for example, are suitable for this purpose. Care should be taken to obtain a sufficiently large number of tissue samples for microbiological examination to be able to better classify the result.
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Affiliation(s)
- Christina Otto-Lambertz
- Department of Orthopaedic Surgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - Ayla Yagdiran
- Department of Orthopaedic Surgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Alessa Lalinka Boschert
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstraße 19-21, 50935, Cologne, Germany
| | - Peer Eysel
- Department of Orthopaedic Surgery, University of Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - Sarah Victoria Walker
- Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstraße 19-21, 50935, Cologne, Germany
- German Centre for Infection Research (DZIF), Hannover, Germany
- Institute for Clinical Microbiology and Hospital Hygiene, Hospital Ludwigsburg, Ludwigsburg, Germany
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