Delayed Propionibacterium acnes surgical site infections occur only in the presence of an implant

Yuta Shiono, Ken Ishii, Shigenori Nagai, Hiroaki Kakinuma, Aya Sasaki, Haruki Funao, Tetsuya Kuramoto, Kenji Yoshioka, Hiroko Ishihama, Norihiro Isogai, Kenichiro Takeshima, Takashi Tsuji, Yasunori Okada, Shigeo Koyasu, Masaya Nakamura, Yoshiaki Toyama, Mamoru Aizawa, Morio Matsumoto

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Abstract

Whether Propionibacterium acnes (P. acnes) causes surgical-site infections (SSI) after orthopedic surgery is controversial. We previously reported that we frequently find P. acnes in intraoperative specimens, yet none of the patients have clinically apparent infections. Here, we tracked P. acnes for 6 months in a mouse osteomyelitis model. We inoculated P. acnes with an implant into the mouse femur in the implant group; the control group was treated with the bacteria but no implant. We then observed over a 6-month period using optical imaging system. During the first 2 weeks, bacterial signals were detected in the femur in the both groups. The bacterial signal completely disappeared in the control group within 28 days. Interestingly, in the implant group, bacterial signals were still present 6 months after inoculation. Histological and scanning electron-microscope analyses confirmed that P. acnes was absent from the control group 6 months after inoculation, but in the implant group, the bacteria had survived in a biofilm around the implant. PCR analysis also identified P. acnes in the purulent effusion from the infected femurs in the implant group. To our knowledge, this is the first report showing that P. acnes causes SSI only in the presence of an implant.

Original languageEnglish
Article number32758
JournalScientific reports
Volume6
DOIs
Publication statusPublished - 2016 Sep 12

ASJC Scopus subject areas

  • General

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    Shiono, Y., Ishii, K., Nagai, S., Kakinuma, H., Sasaki, A., Funao, H., Kuramoto, T., Yoshioka, K., Ishihama, H., Isogai, N., Takeshima, K., Tsuji, T., Okada, Y., Koyasu, S., Nakamura, M., Toyama, Y., Aizawa, M., & Matsumoto, M. (2016). Delayed Propionibacterium acnes surgical site infections occur only in the presence of an implant. Scientific reports, 6, [32758]. https://doi.org/10.1038/srep32758