Propionibacterium as a cause of postneurosurgical infection in patients with dural allografts: report of three cases.
OBJECTIVE
Although Propionibacterium acnes is a common inhabitant of human skin, it is an uncommon pathogen in postoperative infections. We report three cases of postoperative wound infection/osteomyelitis caused by P. acnes.


METHODS
Three patients underwent craniotomy for a supratentorial meningioma and had a dural allograft at the time of closure. The patients presented several weeks after surgery with clinical evidence of a wound infection.


METHODS
All patients were diagnosed with P. acnes infection and treated for this pathogen with appropriate antibiotics. The bone flap was removed in two patients. After antibiotic therapy, all patients demonstrated no further evidence of infection.


CONCLUSIONS
To our knowledge, this is the first published report of P. acnes infection in patients with a dural substitute. The source of infection cannot be confidently ascertained; however, two patients had strains of P. acnes from one brand of graft, which were indistinguishable by pulsed field gel electrophoresis typing.
Jallo
G I
GI
Department of Pediatric Neurosurgery, Institute for Neurology and Neurosurgery, Beth Israel Medical Center, New York, New York 10128, USA.
Koslow
M
M
Hanna
B A
BA
Carson
L A
LA
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003399:Craniotomy; D004388:Dura Mater / Q000637:transplantation*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery; D008579:Meningioma / Q000601:surgery; D010019:Osteomyelitis / Q000382:microbiology*; D011424:Propionibacterium; D012086:Reoperation; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000601:surgery; D014184:Transplantation, Homologous
D000900:Anti-Bacterial Agents