Cutibacterium avidum resists surgical skin antisepsis in the groin—a potential risk factor for periprosthetic joint infection: a quality control study

Antimicrobial Resistance & Infection Control

Stefan Rahm¹  Patrick O. Zingg¹  Stefan P. Kuster²  Yvonne Achermann²  Annelies S. Zinkernagel²  Steven M. Maurer²  Julia Prinz³  Reinhard Zbinden⁴  Annette Moter⁵  Laura Kursawe⁵ 

[1] Department of Orthopedics, University Hospital Balgrist, Zurich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland;Department of Dermatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland;Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland;Institute of Microbiology, Infectious Diseases and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany;

关键词: Cutibacterium avidum;    Cutibacterium;    Skin antisepsis;    Periprosthetic joint infection;    Hip;   

DOI  :  10.1186/s13756-021-00883-1

来源: Springer

【 摘 要 】

BackgroundThe skin commensal Cutibacterium avidum has been recognized as an emerging pathogen for periprosthetic joint infections (PJI). One currently assumes that the early occurring PJIs are a consequence of skin commensals contaminating the peri-implant tissue during surgery. We addressed whether standard skin antisepsis with povidone-iodine/alcohol before total hip arthroplasty (THA) is effective to eliminate colonizing bacteria with focus on C. avidum.MethodsIn a single-center, prospective study, we screened all patients for skin colonizing C. avidum in the groin before THA. Only in the patients positive for C. avidum, we preoperatively repeated skin swabs after the first and third skin antisepsis and antibiotic prophylaxis. We also obtained dermis biopsies for microbiology and fluorescence in situ hybridization (FISH).ResultsFifty-one out of 60 patients (85%) were colonized on the skin with various bacteria, in particular with C. avidum in 12 out of 60. Skin antisepsis eliminated C. avidum in eight of ten (20%) colonized patients undergoing THA. Deeper skin (dermis) biopsies were all culture negative, but FISH detected single positive ribosome-rich C. avidum in one case near sweat glands.ConclusionStandard skin antisepsis was not effective to completely eliminate colonizing C. avidum on the skin in the groin of patients undergoing THA. Colonizing with C. avidum might pose an increased risk for PJI when considering a THA. Novel more effective antisepsis strategies are needed.Trial registration No clinical trial

【 授权许可】

CC BY