title: What is the significance of a positive Propionibacterium acnes culture around a joint replacement?
abstract: The purpose of this study was to show the significance of a positive Propionibacterium acnes sample around a joint replacement. Records from the microbiology laboratory data over a 3-year period were reviewed to identify patients with prosthetic joints from whom Propionibacterium acnes was isolated at least once. The medical records of all those patients were retrieved and the demographic, clinical, microbiological and haematological data were collected and examined. The preoperative values of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were recorded. Fifty patients underwent a routine revision of a joint arthroplasty; six patients had a joint aspiration. Only one patient had further revision surgery for infection. The preoperative values of ESR and CRP were very variable. The presence of a positive sample around a joint arthroplasty is of uncertain significance. Further studies are needed in order to establish uniform criteria for the diagnosis of infection caused by Propionibacterium acnes.
authors.affiliation: Department of Arthroplasty, Royal Orthopaedic Hospital, Birmingham, UK. ad199@doctors.org.uk
authors.forename: A
authors.initials: A
authors.lastname: Dramis
authors.forename: E
authors.initials: E
authors.lastname: Aldlyami
authors.forename: R J
authors.initials: RJ
authors.lastname: Grimer
authors.forename: D J
authors.initials: DJ
authors.lastname: Dunlop
authors.forename: N
authors.initials: N
authors.lastname: O'Connell
authors.forename: T
authors.initials: T
authors.lastname: Elliott
mesh_terms: D000293:Adolescent; D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D007595:Joint Prosthesis / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011425:Propionibacterium acnes / Q000302:isolation & purification* / Q000472:pathogenicity; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology*; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein