Journal article
Cutibacterium colonization of the anterior and lateral thigh: implications for total hip arthroplasty
The bone & joint journal, Vol.102-B(7_Supple_B), pp.52-56
07/2020
DOI: 10.1302/0301-620X.102B7.BJJ-2019-1606.R1
PMID: 32600208
Abstract
Aims
Of growing concern in arthroplasty is the emergence of atypical infections, particularly Cutibacterium (formerly Propionibacterium) sp. infections. Currently, the dermal colonization rate of Cutibacterium about the hip is unknown. Therefore, the aim of this study was to investigate colonization rates of Cutibacterium sp. at locations approximating anterior and posterolateral approaches to the hip joint.
Methods
For this non-randomized non-blinded study, 101 adult patients scheduled for hip or knee surgery were recruited. For each, four 3 mm dermal punch biopsies were collected after administration of anaesthesia, but prior to antibiotics. Prebiopsy skin preparation consisted of a standardized preoperative 2% chlorhexidine skin cleansing protocol and an additional 70% isopropyl alcohol mechanical skin scrub immediately prior to biopsy collection. Two skin samples 10 cm apart were collected from a location approximating a standard direct anterior skin incision, and two samples 10 cm apart were collected from a lateral skin incision (suitable for posterior, direct-lateral, or anterolateral approaches). Samples were cultured for two weeks using a protocol optimized for Cutibacterium.
Results
A total of 23 out of 404 cultures (collected from 101 patients) were positive for a microorganism, with a total of 22 patients having a positive culture (22%). Overall, 15 of the cultures in 14 patients were positive for Cutibacterium sp. (65%), of which Cutibacterium acnes comprised the majority (n = 13; 87%). Other isolated microorganisms include coagulase-negative Staphylococcus (n = 6), Clostridium (n = 1), and Corynebacterium (n = 1). Of all positive cultures, 15 were obtained from the anterior location (65%), of which seven (60%) were from the most proximal biopsy location. However, these findings were not statistically significant (anterior vs lateral, p = 0.076; proximal vs distal, p =0.238).
Conclusion
Approximately 14% (14/101) of the patients demonstrated a positive Cutibacterium colonization about the hip, the majority anteriorly. Given the high colonization rate of Cutibacterium, alternative skin preparations for total hip arthroplasty should be considered. Cite this article: Bone Joint J 2020;102-B(7 Supple B):52–56.
Details
- Title: Subtitle
- Cutibacterium colonization of the anterior and lateral thigh: implications for total hip arthroplasty
- Creators
- Jacob M. Elkins - University of IowaDouglas A. Dennis - University of Tennessee at KnoxvilleLindsay Kleeman-Forsthuber - Colorado Joint ReplacementCharlie C. Yang - Colorado Joint ReplacementTodd M. Miner - Colorado Joint ReplacementJason M. Jennings - University of Denver
- Resource Type
- Journal article
- Publication Details
- The bone & joint journal, Vol.102-B(7_Supple_B), pp.52-56
- DOI
- 10.1302/0301-620X.102B7.BJJ-2019-1606.R1
- PMID
- 32600208
- ISSN
- 2049-4394
- eISSN
- 2049-4408
- Language
- English
- Date published
- 07/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation
- Record Identifier
- 9984304691202771
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