Detection of Cutibacterium acnes in Tissue Samples from Clean Primary Shoulder Surgeries – Part II

Abstract

Objective Research and identification of Cutibacterium acnes (C. acnes) and other microorganisms in deep tissue samples collected in clean shoulder surgeries of patients who did not undergo any previous invasive joint procedure and who had no clinical history of infection.

Methods We analyzed the results of cultures of intraoperative deep tissue samples from 84 patients submitted to primary clean shoulder surgery. Tubes containing culture medium were used for storage and transport of anaerobic agents, prolonged incubation time, and mass spectrometer for diagnosis of bacterial agents.

Results Bacteria growth was evidenced in 34 patients (40.4%) of the 84 included in the study. Of these, 23 had growth of C. acnes in at least one sample of deep tissue collected, corresponding to 27.3% of the total patients. The second most common agent was Staphylococcus epidermidis, present in 7.2% of the total individuals included. We showed a higher relationship between sample positivity and males, a lower mean age, absence of diabetes mellitus, ASA I score, and antibiotic prophylaxis in anesthetic induction with cefuroxime.

Conclusions A high percentage of isolates of different bacteria was found in shoulder tissue samples of patients undergoing clean and primary surgeries, who had no history of previous infection. Identification of C. acnes was high (27.6%), and Staphylococcus epidermidis was the second most frequent agent (7.2%).

Keywords

Cutibacterium acnes - gram-positive bacterial infections - Staphylococcus epidermidis - shoulder

Multicentric study carried out in the Shoulder Surgery Group of the Department of Orthopedics and Traumatology of the Faculty of Sciences Doctors from Santa Casa of São Paulo, “Fernandinho Simonsen Pavilion” (DOT – FCMSCSP) (Director: Professor Maria Fernanda Silber Caffaro); at the German Hospital Oswaldo Cruz in São Paulo (Shoulder Surgeons Group); and at the Special Laboratory of Clinical Microbiology (LEMC) of the Discipline of Infectious Diseases, Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.

Publication History

Received: 15 September 2021

Accepted: 17 August 2022

Article published online:
25 May 2023

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