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Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study

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Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases, Fundació Institut d’Investigació Sanitària Illes Balears (IdISBa), 07120 Palma de Mallorca, Spain
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Infectious Diseases Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
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Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, 39008 Cantabria, Spain
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Infectious Diseases Department, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
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Bone and Joint Infection Unit, Department of Orthopaedic Surgery, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
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Infectious Diseases Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
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Unit of Nosocomial Infection, Hospital Universitari Arnau de Vilanova, 25198 Lleida, Spain
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Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena CSIC, Instituto de Biomedicina de Sevilla (IBiS), Universidad de Sevilla, 41009 Sevilla, Spain
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Infectious Diseases Unit and Clinical Microbiology, Hospital Universitario La Paz, 28046 Madrid, Spain
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Infectious Diseases Department, Corporació Sanitària Parc Taulí, 08208 Barcelona, Spain
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Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, University Hospital Virgen del Rocio, 41013 Sevilla, Spain
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Infectious Diseases Department, Hospital Universitario Cruces, 48903 Vizcaya, Spain
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Infectious Diseases Department, Hospital Universitario Donostia, Instituto BioDonostia, 20014 San Sebastián, Spain
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Infectious Diseases Unit, Internal Medicine Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre “i + 12”, 28041 Madrid, Spain
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Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau-Institut d’Investigació Biomèdica Sant Pau, Departament of Medicine, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain
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Department of Infectious Diseases, Hospital Clínic of Barcelona, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain
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Microbiologic Department, Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
*
Author to whom correspondence should be addressed.
Membership of the GEIO and REIPI are provided in the Acknowledgments.
Academic Editor: Marc Maresca
Antibiotics 2021, 10(5), 475; https://doi.org/10.3390/antibiotics10050475
Received: 28 March 2021 / Revised: 13 April 2021 / Accepted: 19 April 2021 / Published: 21 April 2021
This retrospective, multicenter observational study aimed to describe the outcomes of surgical and medical treatment of C. acnes-related prosthetic joint infection (PJI) and the potential benefit of rifampin-based therapies. Patients with C. acnes-related PJI who were diagnosed and treated between January 2003 and December 2016 were included. We analyzed 44 patients with C. acnes-related PJI (median age, 67.5 years (IQR, 57.3–75.8)); 75% were men. The majority (61.4%) had late chronic infection according to the Tsukayama classification. All patients received surgical treatment, and most antibiotic regimens (43.2%) included β-lactam. Thirty-four patients (87.17%) were cured; five showed relapse. The final outcome (cure vs. relapse) showed a nonsignificant trend toward higher failure frequency among patients with previous prosthesis (OR: 6.89; 95% CI: 0.80–58.90) or prior surgery and infection (OR: 10.67; 95% IC: 1.08–105.28) in the same joint. Patients treated with clindamycin alone had a higher recurrence rate (40.0% vs. 8.8%). Rifampin treatment did not decrease recurrence in patients treated with β-lactams. Prior prosthesis, surgery, or infection in the same joint might be related to recurrence, and rifampin-based combinations do not seem to improve prognosis. Debridement and implant retention appear a safe option for surgical treatment of early PJI. View Full-Text
Keywords: Cutibacterium acnes; prosthetic joint infection; surgical and medical treatment Cutibacterium acnes; prosthetic joint infection; surgical and medical treatment
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MDPI and ACS Style

Vilchez, H.H.; Escudero-Sanchez, R.; Fernandez-Sampedro, M.; Murillo, O.; Auñón, Á.; Rodríguez-Pardo, D.; Jover-Sáenz, A.; del Toro, M.D.; Rico, A.; Falgueras, L.; Praena-Segovia, J.; Guío, L.; Iribarren, J.A.; Lora-Tamayo, J.; Benito, N.; Morata, L.; Ramirez, A.; Riera, M.; Study Group on Osteoarticular Infections; the Spanish Network for Research in Infectious Pathology. Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study. Antibiotics 2021, 10, 475. https://doi.org/10.3390/antibiotics10050475

AMA Style

Vilchez HH, Escudero-Sanchez R, Fernandez-Sampedro M, Murillo O, Auñón Á, Rodríguez-Pardo D, Jover-Sáenz A, del Toro MD, Rico A, Falgueras L, Praena-Segovia J, Guío L, Iribarren JA, Lora-Tamayo J, Benito N, Morata L, Ramirez A, Riera M, Study Group on Osteoarticular Infections, the Spanish Network for Research in Infectious Pathology. Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study. Antibiotics. 2021; 10(5):475. https://doi.org/10.3390/antibiotics10050475

Chicago/Turabian Style

Vilchez, Helem H., Rosa Escudero-Sanchez, Marta Fernandez-Sampedro, Oscar Murillo, Álvaro Auñón, Dolors Rodríguez-Pardo, Alfredo Jover-Sáenz, Mª D. del Toro, Alicia Rico, Luis Falgueras, Julia Praena-Segovia, Laura Guío, José A. Iribarren, Jaime Lora-Tamayo, Natividad Benito, Laura Morata, Antonio Ramirez, Melchor Riera, Study Group on Osteoarticular Infections, and the Spanish Network for Research in Infectious Pathology. 2021. "Prosthetic Shoulder Joint Infection by Cutibacterium acnes: Does Rifampin Improve Prognosis? A Retrospective, Multicenter, Observational Study" Antibiotics 10, no. 5: 475. https://doi.org/10.3390/antibiotics10050475

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