Propionibacterium acnes in shoulder surgery: is loss of hair protective for infection?

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• 作者：Robert Hudek ; MD^a ; ^{robert@hudek.de" class="auth_mail" title="E-mail the corresponding author} ; Frank Sommer ; MD^b ; Ayman F. Abdelkawi ; MD^a ; Martina Kerwat ; MD^b ; Hans-Helge M&uuml ; ller ; PhD^c ; Frank Gohlke ; MD^a
• 关键词：Propionibacterium acnes ; P acnes ; infection ; shoulder ; surgery ; skin ; loss of hair ; hair
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：25
• 期：6
• 页码：973-980
• 全文大小：258 K

文摘

m>Propionibacterium acnesm> (m>P acnesm>) has been linked to chronic infections in shoulder surgery. It was recently observed during first-time shoulder surgery in healthy patients at a rate between 36% and 56%. Male gender and the anterolateral approach were reported risk factors. Because the skin biology greatly differs, we aimed to correlate skin complaints with m>P acnesm>–positive intraoperative cultures from different tissue layer samples in patients undergoing shoulder surgery for the first time.

Methods

Intraoperative samples (1 skin, 1 superficial, 1 deep tissue, and 1 control sample) from 112 patients (70 men, 42 women; aged 59.2 years) were cultured. The association between the presence of m>P acnesm> in the deep or superficial tissue, or both, and 10 items of a validated preoperative questionnaire for skin pathology was explored.

Results

The cultures were positive for m>P acnesm> in 38.4% (n = 43) of the cases. Skin samples were positive for m>P acnesm> in 8% (n = 9), superficial samples were positive in 23% (n = 26), and deep samples were positive in 30% (n = 34). Self-reported “loss of hair” was significantly negatively associated with the presence of m>P acnesm> in the superficial or deep tissue sample (m>Pm> = .00028).

Discussion

Patients who report having “loss of hair” show fewer m>P acnesm>–positive cultures in intraoperative tissue samples taken during open shoulder surgery. Whether this subgroup is at a lesser risk for m>P acnesm> infections remains to be substantiated.

Level of evidence

Basic Science Study; Microbiology