Articles | Volume 8, issue 2
https://doi.org/10.5194/jbji-8-143-2023
© Author(s) 2023. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
https://doi.org/10.5194/jbji-8-143-2023
© Author(s) 2023. This work is distributed under
the Creative Commons Attribution 4.0 License.
the Creative Commons Attribution 4.0 License.
Cutibacterium acnes in spine tissue: characteristics and outcomes of non-hardware-associated vertebral osteomyelitis
Matteo Passerini
CORRESPONDING AUTHOR
Division of Public Health, Infectious Diseases, and Occupational
Medicine, Mayo Clinic, Rochester, MN, USA
Julian Maamari
Division of Public Health, Infectious Diseases, and Occupational
Medicine, Mayo Clinic, Rochester, MN, USA
Don Bambino Geno Tai
Division of Infectious Diseases and International Medicine, Department
of Medicine, University of Minnesota, Minneapolis, MN, USA
Robin Patel
Division of Clinical Microbiology, Department of Laboratory Medicine
and Pathology, Mayo Clinic, Rochester, MN, USA
Aaron J. Tande
Division of Public Health, Infectious Diseases, and Occupational
Medicine, Mayo Clinic, Rochester, MN, USA
Zelalem Temesgen
Division of Public Health, Infectious Diseases, and Occupational
Medicine, Mayo Clinic, Rochester, MN, USA
Elie F. Berbari
CORRESPONDING AUTHOR
Division of Public Health, Infectious Diseases, and Occupational
Medicine, Mayo Clinic, Rochester, MN, USA
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Matteo Passerini, Julian Maamari, Tarek Nayfeh, Leslie C. Hassett, Aaron J. Tande, Mohammad H. Murad, Zelalem Temesgen, and Elie F. Berbari
J. Bone Joint Infect., 7, 249–257, https://doi.org/10.5194/jbji-7-249-2022, https://doi.org/10.5194/jbji-7-249-2022, 2022
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Despite a growing interest in oral therapy for native vertebral osteomyelitis, there is no evidence to recommend oral or parenteral therapy. From our single-center experience combined with a systematic review and a meta-analysis of the available literature, there is insufficient evidence to conclude that there is a difference in proportion of failure and relapse between an early switch to oral antibiotics and prolonged parenteral therapy. Further studies are needed to increase the evidence.
Francesco Petri, Omar Mahmoud, Said El Zein, Ahmad Nassr, Brett A. Freedman, Jared T. Verdoorn, Aaron J. Tande, and Elie F. Berbari
J. Bone Joint Infect., 9, 173–182, https://doi.org/10.5194/jbji-9-173-2024, https://doi.org/10.5194/jbji-9-173-2024, 2024
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In recent years, there has been an increase in scientific production on native vertebral osteomyelitis (NVO), a condition whose incidence is rising and that can be highly detrimental to health. However, there is no consensus on the definition of this syndrome in the medical community. Therefore, we propose a new framework to synthesize the diagnostic tools at our disposal. This can help to advance research further and guide patient care more effectively.
Nicolás Cortés-Penfield, Don Bambino Geno Tai, and Angela Hewlett
J. Bone Joint Infect., 9, 161–165, https://doi.org/10.5194/jbji-9-161-2024, https://doi.org/10.5194/jbji-9-161-2024, 2024
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This survey study describes the composition of US-based orthopedic infectious diseases (Ortho ID) teams across more than a dozen large academic medical centers, finding many institutions have dedicated Ortho ID clinics or inpatient services. These teams are highly valued by both ID clinicians and surgeons for engendering strong multidisciplinary relationships and improving patient outcomes.
Said El Zein, Elie F. Berbari, Allison M. LeMahieu, Anil Jagtiani, Parham Sendi, Abinash Virk, Mark E. Morrey, and Aaron J. Tande
J. Bone Joint Infect., 9, 107–115, https://doi.org/10.5194/jbji-9-107-2024, https://doi.org/10.5194/jbji-9-107-2024, 2024
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Our study investigated olecranon septic bursitis treatment, focusing on postsurgical antibiotic use. Analyzing 22 years of Mayo Clinic data, we found that smoking and not administering antibiotics following surgery led to poorer outcomes. A 3-week antibiotic course following surgery was most effective. Our findings suggest that a subset of patients may benefit from longer courses of antibiotics; however, further research is needed to confirm these findings.
Pansachee Damronglerd, Eibhlin Higgins, Madiha Fida, Don Bambino Geno Tai, Aaron J. Tande, Matthew P. Abdel, and Omar M. Abu Saleh
J. Bone Joint Infect., 9, 99–106, https://doi.org/10.5194/jbji-9-99-2024, https://doi.org/10.5194/jbji-9-99-2024, 2024
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This work investigates periprosthetic joint infection (PJI) caused by rapidly growing mycobacteria (RGM) following total joint arthroplasty. Eight patients were identified as part of a retrospective review. The isolated RGM species included Mycobacterium abscessus (three cases), M. fortuitum (three cases), and one case each of M. immunogenum and M. mageritense. We provide novel insights into the successful treatment of PJIs caused by newly identified RGM (M. immunogenum and M. mageritense).
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J. Bone Joint Infect., 8, 125–131, https://doi.org/10.5194/jbji-8-125-2023, https://doi.org/10.5194/jbji-8-125-2023, 2023
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This retrospective case-matched study evaluated males and females with staphylococcal PJI (periprosthetic joint infection) treated with two-stage exchange arthroplasty. We matched 156 males and females for age, type of staphylococcal infection, and joint involved. We compared clinical parameters related to presentation, treatment, and outcome. We did not find a statistically significant difference in outcome between males and females treated with the same surgical approach at our institution.
Kareme D. Alder, Anthony P. Fiegen, Matthew M. Rode, Don Bambino Geno Tai, Gina A. Suh, Abinash Virk, and Nicholas Pulos
J. Bone Joint Infect., 8, 39–44, https://doi.org/10.5194/jbji-8-39-2023, https://doi.org/10.5194/jbji-8-39-2023, 2023
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We present the first published case of bilateral extensor tenosynovitis caused by Coxiella burnetii. C. burnetii should be considered in patients with inflammatory osteoarticular disease, including tenosynovitis, when conventional cultures are negative especially in elderly, male, or immunocompromised patients with exposure to animals.
Matteo Passerini, Julian Maamari, Tarek Nayfeh, Leslie C. Hassett, Aaron J. Tande, Mohammad H. Murad, Zelalem Temesgen, and Elie F. Berbari
J. Bone Joint Infect., 7, 249–257, https://doi.org/10.5194/jbji-7-249-2022, https://doi.org/10.5194/jbji-7-249-2022, 2022
Short summary
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Despite a growing interest in oral therapy for native vertebral osteomyelitis, there is no evidence to recommend oral or parenteral therapy. From our single-center experience combined with a systematic review and a meta-analysis of the available literature, there is insufficient evidence to conclude that there is a difference in proportion of failure and relapse between an early switch to oral antibiotics and prolonged parenteral therapy. Further studies are needed to increase the evidence.
Talha Riaz, Matthew Howard, Felix Diehn, Aaron Joseph Tande, Courtney Ross, Paul Huddleston, and Elie Berbari
J. Bone Joint Infect., 7, 213–219, https://doi.org/10.5194/jbji-7-213-2022, https://doi.org/10.5194/jbji-7-213-2022, 2022
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In this study, we prospectively enrolled patients with a suspected diagnosis of native vertebral osteomyelitis (NVO) undergoing image-guided needle aspiration of the intervertebral disc. Based on this pilot study, a high manual cell count or a high neutrophilic predominance from the disc aspirate was associated with the diagnosis of NVO.
Melissa Karau, Suzannah Schmidt-Malan, Jay Mandrekar, Dario Lehoux, Raymond Schuch, Cara Cassino, and Robin Patel
J. Bone Joint Infect., 7, 169–175, https://doi.org/10.5194/jbji-7-169-2022, https://doi.org/10.5194/jbji-7-169-2022, 2022
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Orthopedic infections are complex, often requiring surgical intervention and prolonged antibiotic therapy, especially in the presence of a foreign body. In a rabbit model of implant-associated methicillin-resistant Staphylococcus aureus osteomyelitis, the lysins exebacase and CF-296 delivered locally with and without systemic daptomycin resulted in lower bacterial counts than those of control animals, showing a promising complement to conventional antibiotics in implant-associated infections.
Katharine Dobos, Gina A. Suh, Aaron J. Tande, and Shanthi Kappagoda
J. Bone Joint Infect., 7, 137–141, https://doi.org/10.5194/jbji-7-137-2022, https://doi.org/10.5194/jbji-7-137-2022, 2022
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This paper describes five cases of prosthetic joint infection (PJI) caused by Mycobacterium avium complex (MAC). Infections occurred in both immune competent and immunosuppressed patients. Interestingly, using the Musculoskeletal Infection Society diagnostic criteria for PJI may miss some cases of MAC PJI. Treatment courses and outcomes are described.
Julian Maamari, Aaron J. Tande, Felix Diehn, Don Bambino Geno Tai, and Elie F. Berbari
J. Bone Joint Infect., 7, 23–32, https://doi.org/10.5194/jbji-7-23-2022, https://doi.org/10.5194/jbji-7-23-2022, 2022
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The yearly incidence of native vertebral osteomyelitis (NVO) is increasing. In 2013 the prevalence of NVO in the USA was 5.4 cases per 100 000. Delays in the diagnosis of NVO remain common, in part due to the insidious nature of the infection and its related symptoms. The mean time between the onset of symptoms to diagnosis of NVO is 45.5 d. We herein review available and novel diagnostic modalities at the disposal of healthcare providers to reach an accurate and timely diagnosis of NVO.
Miao Xian Zhou, Elie F. Berbari, Cory G. Couch, Scott F. Gruwell, and Alan B. Carr
J. Bone Joint Infect., 6, 363–366, https://doi.org/10.5194/jbji-6-363-2021, https://doi.org/10.5194/jbji-6-363-2021, 2021
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This was written to outline Mayo Clinic guidelines on prophylactic antibiotics prior to invasive procedures in patients with prosthetic joints. There is an emphasis on maintaining optimal oral health to reduce the risk of infection to minimize the patient’s risk of PJI.
Don Bambino Geno Tai, Nathan J. Brinkman, Omar Abu Saleh, Douglas R. Osmon, Matthew P. Abdel, and Christina G. Rivera
J. Bone Joint Infect., 6, 147–150, https://doi.org/10.5194/jbji-6-147-2021, https://doi.org/10.5194/jbji-6-147-2021, 2021
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Antibiotics are frequently used in bone cement during joint replacements or treatment of bone and joint infections. Amikacin is rarely used in bone cement, particularly the liquid formulation. We describe a series of patients in which liquid amikacin was incorporated into bone cement. We did not observe the occurrence of adverse drug reactions definitively attributed to its use. All patients had favorable outcomes.
Stephanie L. Grach and Aaron J. Tande
J. Bone Joint Infect., 6, 39–42, https://doi.org/10.5194/jbji-6-39-2020, https://doi.org/10.5194/jbji-6-39-2020, 2020
Related subject area
Subject: Spinal infections | Topic: Infectious
Vertebral osteomyelitis and epidural abscess due to Listeria monocytogenes – case report and review of literature
A rare case of invasive non-typeable Haemophilus influenzae spondylodiscitis and periprosthetic joint infection
Olayinka Ibironke Adebolu, Jennifer Sommer, Abiodun Benjamin Idowu, Nicole Lao, and Talha Riaz
J. Bone Joint Infect., 7, 75–79, https://doi.org/10.5194/jbji-7-75-2022, https://doi.org/10.5194/jbji-7-75-2022, 2022
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This is a case report and literature review that describes Listeria monocytogenes as a rare cause of native vertebral osteomyelitis. This work reviewed previous published cases (nine cases to the best of our knowledge) and documented the clinical course, diagnostic challenges, and treatment of the disease. This case report aims to inform clinicians of the possibility of Listeria monocytogenes invading native joints in patients with or without risk factors.
Kevin Sermet, François Demaeght, Isabelle Alcaraz, Nathalie Viget, Julie Dauenhauer, Eric Senneville, and Olivier Robineau
J. Bone Joint Infect., 6, 207–209, https://doi.org/10.5194/jbji-6-207-2021, https://doi.org/10.5194/jbji-6-207-2021, 2021
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Non-typeable Haemophilus influenzae (NTHi) is here described for the first time as responsible for an invasive infection involving blood, vertebral and joint infection in a 79-year-old woman. It was triggered by an asymptomatic sinus condition. Surgical drainage and antibiotic therapy allowed recovery. This case shows that a full cartography of NTHi infection is unavoidable and may reveal unknown dissemination mechanisms.
Cited articles
Abolnik, I. Z., Eaton, J. V., and Sexton, D. J.: Propionibacterium acnes
vertebral osteomyelitis following lumbar puncture: case report and review,
Clin. Infect. Dis., 21, 694–695, https://doi.org/10.1093/clinids/21.3.694,
1995.
Achermann, Y., Goldstein, E. J. C., Coenye, T., and Shirtliff, M. E.:
Propionibacterium acnes: from Commensal to Opportunistic Biofilm-Associated
Implant, Pathogen., Clin. Microbiol. Rev., 27, 419–440, https://doi.org/10.1128/CMR.00092-13, 2014.
Beatty, N. R., Lutz, C., Boachie-Adjei, K., Leynes, T. A., Lutz, C., and
Lutz, G.: Spondylodiscitis due to Cutibacterium acnes following lumbosacral
intradiscal biologic therapy: a case report, Regen. Med., 14, 823–829,
https://doi.org/10.2217/rme-2019-0008, 2019.
Berbari, E. F., Kanj, S. S., Kowalski, T. J., Darouiche, R. O., Widmer, A.
F., Schmitt, S. K., Hendershot, E. F., Holtom, P. D., Huddleston, P. M.,
Petermann, G. W., and Osmon, D. R.: 2015 Infectious Diseases Society of
America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment
of Native Vertebral Osteomyelitis in Adultsa, Clin. Infect. Dis., 61,
e26–e46, https://doi.org/10.1093/cid/civ482, 2015.
Boisrenoult, P.: Cutibacterium acnes prosthetic joint infection: Diagnosis
and treatment, Orthop. Traumatol. Surg. Res., 104, S19–S24,
https://doi.org/10.1016/j.otsr.2017.05.030, 2018.
Carragee, E. J.: Pyogenic vertebral osteomyelitis., J. Bone Joint Surg. Am.,
79, 874–80, https://doi.org/10.2106/00004623-199706000-00011, 1997.
Cobo, F., Borrego, J., Rodríguez-Granger, J., Sampedro, A., and
Navarro-Marí, J. M.: A rare case of pleural infection due to
Propionibacterium acnes (Cutibacterium acnes), Rev. Esp. Quimioter., 31,
173–174, 2018.
Grice, E. A., Kong, H. H., Conlan, S., Deming, C. B., Davis, J., Young, A.
C., NISC Comparative Sequencing Program, N. C. S., Bouffard, G. G.,
Blakesley, R. W., Murray, P. R., Green, E. D., Turner, M. L., and Segre, J.
A.: Topographical and temporal diversity of the human skin microbiome,
Science, 324, 1190–1192, https://doi.org/10.1126/science.1171700, 2009.
Harris, A. E., Hennicke, C., Byers, K., and Welch, W. C.: Postoperative
discitis due to Propionibacterium acnes: a case report and review of the
literature, Surg. Neurol., 63, 538–541,
https://doi.org/10.1016/j.surneu.2004.06.012, 2005.
Hernández-Palazón, J., Puertas-García, J. P.,
Martínez-Lage, J. F., and Tortosa, J. A.: Lumbar spondylodiscitis
caused by Propionibacterium acnes after epidural obstetric analgesia.,
Anesth. Analg., 96, 1486–1488,
https://doi.org/10.1213/01.ANE.0000055819.35383.D3, 2003.
Iyer, S., Louie, P. K., Nolte, M. T., and Phillips, F. M.: The Relationship
Between Low-Grade Infection and Degenerative Disk Disease: A Review of Basic
Science and Clinical Data, J. Am. Acad. Orthop. Surg., 27, 509–518,
https://doi.org/10.5435/JAAOS-D-18-00257, 2019.
Khalil, J. G., Gandhi, S. D., Park, D. K., and Fischgrund, J. S.:
Cutibacterium acnes in Spine Pathology: Pathophysiology, Diagnosis, and
Management, J. Am. Acad. Orthop. Surg., 27, e633–e640,
https://doi.org/10.5435/JAAOS-D-17-00698, 2019.
Kowalski, T. J., Berbari, E. F., Huddleston, P. M., Steckelberg, J. M., and
Osmon, D. R.: Propionibacterium acnes vertebral osteomyelitis: seek and ye
shall find?, Clin. Orthop. Relat. Res., 461, 25–30,
https://doi.org/10.1097/BLO.0b013e318073c25d, 2007.
Leheste, J. R., Ruvolo, K. E., Chrostowski, J. E., Rivera, K., Husko, C.,
Miceli, A., Selig, M. K., Brüggemann, H., and Torres, G.: P.
acnes-Driven Disease Pathology: Current Knowledge and Future Directions,
Front. Cell. Infect. Microbiol., 7, 81,
https://doi.org/10.3389/fcimb.2017.00081, 2017.
MacLean, S. B. M., Phadnis, J., Ling, C. M., and Bain, G. I.: Application of
dermal chlorhexidine antisepsis is ineffective at reducing
Proprionibacterium acnes colonization in shoulder surgery, Shoulder Elb., 11, 98–105,
https://doi.org/10.1177/1758573218755570, 2019.
Mercieca, L., Mangion, J., Cefai, J., Bezzina, T., Schwaiger, C., Micallef,
D., Corso, R., Scerri, L., Boffa, M. J., Caruana, P., Clark, E., and
Aquilina, S.: The Antibiotic Susceptibility Profile of Cutibacterium Acnes
in Maltese Patients with Acne, J. Clin. Aesthet. Dermatol., 13, 11–16,
2020.
Spellberg, B., Aggrey, G., Brennan, M. B., Footer, B., Forrest, G.,
Hamilton, F., Minejima, E., Moore, J., Ahn, J., Angarone, M., Centor, R. M.,
Cherabuddi, K., Curran, J., Davar, K., Davis, J., Dong, M. Q., Ghanem, B.,
Hutcheon, D., Jent, P., Kang, M., Lee, R., McDonald, E. G., Morris, A. M.,
Reece, R., Schwartz, I. S., So, M., Tong, S., Tucker, C., Wald-Dickler, N.,
Weinstein, E. J., Williams, R., Yen, C., Zhou, S., Lee, T. C., Baden, R.,
Bedard-Dallare, S., Beltran, C., Blythe, M., Brass, E., Chi, S., Coffey, C.,
Cowart, M., Diaz, A., Dwyer, J., Jordan Villegas, A., Khan, E., Martinez,
J., Mattappallil, A., Meshkaty, N., Patel, A., Pullen, M., Rajan, S.,
Saxinger, L., Tirupathi, R., Trivedi, J., Vilchez-Molina, G., Werge, D., and
Werge, D.: Use of Novel Strategies to Develop Guidelines for Management of
Pyogenic Osteomyelitis in Adults, JAMA Netw. Open, 5, e2211321,
https://doi.org/10.1001/jamanetworkopen.2022.11321, 2022.
Uçkay, I., Dinh, A., Vauthey, L., Asseray, N., Passuti, N., Rottman, M.,
Biziragusenyuka, J., Riché, A., Rohner, P., Wendling, D., Mammou, S.,
Stern, R., Hoffmeyer, P., and Bernard, L.: Spondylodiscitis due to
Propionibacterium acnes: report of twenty-nine cases and a review of the
literature, Clin. Microbiol. Infect., 16, 353–358,
https://doi.org/10.1111/j.1469-0691.2009.02801.x, 2010.
van Steensel, M. A. M. and Goh, B. C.: Cutibacterium acnes: Much ado about
maybe nothing much., Exp. Dermatol., 30, 1471–1476,
https://doi.org/10.1111/exd.14394, 2021.
Weihe, R., Taghlabi, K., Lowrance, M., Reeves, A., Jackson, S. R., Burton,
D. C., and El Atrouni, W.: Culture Yield in the Diagnosis of Native
Vertebral Osteomyelitis: A Single Tertiary Center Retrospective Case Series
With Literature Review, Open Forum Infect. Dis., 7, 9,
https://doi.org/10.1093/ofid/ofac026, 2022.
Kanafani, Z. A.: Invasive Cutibacterium (formerly Propionibacterium)
infections, in: UpToDate, edited by: Sexton, D. J. and Hall, K. K., https://www.uptodate.com/contents/invasive-cutibacterium-formerly-propionibacterium-infections, last access: 1 October 2022.
Zimmermann, P. and Curtis, N.: The role of Cutibacterium acnes in
auto-inflammatory bone disorders, Eur. J. Pediatr., 178, 89–95,
https://doi.org/10.1007/s00431-018-3263-2, 2019.
Short summary
Physicians have difficulties interpreting the isolation of Cutibacterium acnes in the spine tissue. Here we provide the experience of our center about this topic, adding data that can help physicians in their choices. Our results show that some clinical, radiological, and microbiological features can help distinguish patients to treat or not to treat. Moreover, treatment with parenteral beta-lactams appears to be effective, but targeted oral therapy could be a valid alternative.
Physicians have difficulties interpreting the isolation of Cutibacterium acnes in the spine...