Are Cutibacterium acnes delivered from skin to deep tissues in primary reverse shoulder arthroplasty? A prospective study.

INTRODUCTION: The objective of this study is to determine whether the deep tissues are inoculated during surgery with the Cutibacterium acnes still present in the skin after the surgical preparation in reverse shoulder arthroplasties. MATERIALS AND METHODS: Prospective study including patients undergoing surgery with reverse shoulder arthroplasty. All the patients received preoperative antibiotic prophylaxis with cefazolin (2 g IV) and the skin was prepared with 2% chlorhexidine gluconate and 70% isopropyl alcohol. From all the patients, 9 cultures were obtained after the antibiotic was administrated and the skin surgically prepared. The cultures were sent to isolate C. acnes. DNA was extracted from the C. acnes isolated colonies. Isolate nucleotide distances were calculated using the Genome-based distance matrix calculator from the Enveomics collection toolbox. RESULTS: The study included 90 patients. C. acnes was isolated in 24 patients (26.6%) with a total of 61 positive cultures. There were 12 phylotype II, 27 IB and 22 IA. In 9 patients, C. acnes was present in both skin and deep tissues, and they constituted the sample to be studied by means of genomic analysis. In 7 out of the 9 patients, deep tissue samples clustered closer to at least one of its corresponding skin isolates when compared to the other independent bacterial ones. CONCLUSIONS: The C. acnes present in the skin at the beginning of the surgery are the same as those found in the deep tissues at the end of the surgery. This result strengthens the possibility that the C. acnes is delivered from the skin to the deep tissues.

Eikenella corrodens causing deep-seated infections. Six-year experience in a University Hospital in Madrid / Infecciones por Eikenella corrodens en localizaciones profundas. Experiencia de 6 años en un hospital universitario de Madrid

INTRODUCTION: Eikenella corrodens (EC) is part of the normal microbiota of the oropharynx and a recognised opportunistic pathogen. It is mainly involved in head and neck infections, but it has also been identified as a cause of pleuropulmonary and intraabdominal infections. Its identification could be difficult due to its fastidious growth requirements, especially in the context of polymicrobial infection and is probably underreported. METHODS: We carried out a retrospective 5-year review of clinical charts and laboratory database. RESULTS: We describe the clinical and microbiological characteristics of 9 deep-seated infections caused by EC, diagnosed in locations different from the head and neck. CONCLUSION: EC deep-seated infections are often found in patients with comorbid conditions and a history of interventional procedures. Due to the characteristic torpid evolution of EC abscesses, imaging to assess the necessity of debridement and avoid early cessation of antibiotics is necessary

INTRODUCCIÓN: Eikenella corrodens (EC) es parte de la microbiota habitual orofaríngea y un conocido patógeno oportunista. Está involucrado principalmente en infecciones de cabeza y cuello, pero también causa de infecciones pleuropulmonares e intraabdominales. Su identificación podría ser difícil debido a sus exigentes requisitos de crecimiento, especialmente en el contexto de la infección polimicrobiana y probablemente sea un microorganismo infradiagnosticado. MÉTODOS: Realizamos una revisión retrospectiva de 5 años de las historias clínicas y la base de datos del laboratorio. RESULTADOS: Describimos las características clínicas y microbiológicas de 9 casos de infecciones en localizaciones profundas causadas por EC, diagnosticadas en localizaciones diferentes de la cabeza y el cuello. CONCLUSIONES: Las infecciones profundas por EC aparecen con frecuencia en pacientes con comorbilidades y antecedentes de procedimientos invasivos. Dada la evolución tórpida característica de los abscesos causados por EC, emplear técnicas de imagen para valorar la necesidad de desbridamiento y evitar la retirada prematura de los antimicrobianos

Eikenella corrodens causing deep-seated infections. Six-year experience in a University Hospital in Madrid.

INTRODUCTION: Eikenella corrodens (EC) is part of the normal microbiota of the oropharynx and a recognised opportunistic pathogen. It is mainly involved in head and neck infections, but it has also been identified as a cause of pleuropulmonary and intraabdominal infections. Its identification could be difficult due to its fastidious growth requirements, especially in the context of polymicrobial infection and is probably underreported. METHODS: We carried out a retrospective 5-year review of clinical charts and laboratory database. RESULTS: We describe the clinical and microbiological characteristics of 9 deep-seated infections caused by EC, diagnosed in locations different from the head and neck. CONCLUSION: EC deep-seated infections are often found in patients with comorbid conditions and a history of interventional procedures. Due to the characteristic torpid evolution of EC abscesses, imaging to assess the necessity of debridement and avoid early cessation of antibiotics is necessary.

Infección de herida por mordedura de gato / Cat bite wound infection

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