PMID- 27036925
OWN - NLM
STAT- MEDLINE
DCOM- 20171128
LR  - 20181202
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 31
IP  - 9
DP  - 2016 Sep
TI  - Clinical Analysis of Propionibacterium acnes Infection After Total Knee 
      Arthroplasty.
PG  - 1986-9
LID - S0883-5403(16)00145-5 [pii]
LID - 10.1016/j.arth.2016.02.025 [doi]
AB  - BACKGROUND: Propionibacterium acnes is a common cause of upper extremity 
      arthroplasty infection and usually presents in an indolent subacute fashion. It 
      is not well described how total knee arthroplasty (TKA) patients infected with P 
      acnes present. METHODS: We retrospectively compared patients undergoing revision 
      TKA for infection from P acnes and methicillin-sensitive Staphylococcal aureus 
      (MSSA) in our institutional infection database. Patients were classified as 
      having a periprosthetic joint infection based on the Musculoskeletal Infection 
      Society criteria and were excluded if they had a polymicrobial culture. Patient 
      demographics, preoperative laboratory values, microbiology data, and synovial 
      fluid white blood cell (WBC) counts were analyzed. RESULTS: Sixteen patients with 
      a P acnes and 30 with an MSSA TKA periprosthetic joint infection were identified. 
      Median erythrocyte sedimentation rate was significantly higher in the MSSA group 
      compared to the P acnes group (56.0 mm/h; interquartile range [IQR], 44.3-72.9 vs 
      23.0 mm/h; IQR, 18.5-52.0; respectively, P = .03) as were C-reactive protein 
      levels (5.9 mg/dL; IQR, 3.7-26.9 vs 2.0 mg/dL; IQR, 0.5-14.0; respectively, P = 
      .04). WBC count, synovial fluid WBC, and percentage of synovial polymorphonuclear 
      cells were similar between groups. Mean time to culture was 8.3 +/- 2.0 days in the 
      P acnes group and 1.8 +/- 0.8 days in the MSSA group. CONCLUSION: P acnes TKA 
      infections are associated with more acute inflammatory symptoms than typically 
      appreciated, and long hold anaerobic cultures up to 14 days are necessary to 
      accurately identify this organism as the causative agent of TKA periprosthetic 
      infection.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Nodzo, Scott R
AU  - Nodzo SR
AD  - Department of Orthopedics, Hospital for Special Surgery, New York, New York.
FAU - Westrich, Geoffrey H
AU  - Westrich GH
AD  - Department of Orthopedics, Hospital for Special Surgery, New York, New York.
FAU - Henry, Michael W
AU  - Henry MW
AD  - Department of Infectious Disease, Hospital for Special Surgery, New York, New 
      York.
FAU - Miller, Andy O
AU  - Miller AO
AD  - Department of Infectious Disease, Hospital for Special Surgery, New York, New 
      York.
LA  - eng
PT  - Journal Article
DEP - 20160223
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
RN  - 9007-41-4 (C-Reactive Protein)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Arthritis, Infectious/*diagnosis/microbiology
MH  - Arthroplasty, Replacement, Knee/*adverse effects
MH  - Blood Sedimentation
MH  - C-Reactive Protein/analysis
MH  - Female
MH  - Gram-Positive Bacterial Infections/*diagnosis/microbiology
MH  - Humans
MH  - Leukocyte Count
MH  - Male
MH  - Middle Aged
MH  - Neutrophils
MH  - *Propionibacterium acnes
MH  - Prosthesis-Related Infections/*diagnosis/microbiology
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Propionibacterium acnes
OT  - clinical presentation
OT  - complications
OT  - periprosthetic infection
OT  - total knee arthroplasty
EDAT- 2016/04/03 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/04/03 06:00
PHST- 2015/11/02 00:00 [received]
PHST- 2016/01/13 00:00 [revised]
PHST- 2016/02/08 00:00 [accepted]
PHST- 2016/04/03 06:00 [entrez]
PHST- 2016/04/03 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
AID - S0883-5403(16)00145-5 [pii]
AID - 10.1016/j.arth.2016.02.025 [doi]
PST - ppublish
SO  - J Arthroplasty. 2016 Sep;31(9):1986-9. doi: 10.1016/j.arth.2016.02.025. Epub 2016 
      Feb 23.