How are implant-associated Cutibacterium (Propionibacterium) infections diagnosed?

Updated: Dec 03, 2019
  • Author: Sajeev Handa, MBBCh, BAO, LRCSI, LRCPI; Chief Editor: John L Brusch, MD, FACP  more...
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In order to successfully diagnose implant-associated infections, multiple conventional tissue cultures, sonification of the removed implant or its mobile parts, and/or synovial fluid aspiration is recommended. Sonification is a method whereby bacteria are dislodged from the surface of an implant and biofilm clumps are broken into a suspension of single cells. The sonification fluid is then plated onto aerobic and anaerobic sheep agar plates and inoculated into a thioglycolate broth. This is then incubated for 7 days and the CFU/mL is calculated. [6]

In prosthetic joint infections, prolonged incubation beyond 13 days of aspirates and or of blood cultures is recommended to optimize the recovery of C acnes. [20]

CNS shunt infections require evaluation of cerebrospinal fluid (CSF) and blood cultures, particularly in cases of suspected ventriculoatrial shunt infections, in which case the yield may be higher. In the review performed by Conen et al, infection was defined by the first positive culture of CSF, wound swab, or shunt tip specimen; the initiation of an appropriate antimicrobial treatment for shunt-associated infection; or surgery at the site of the shunt (whichever occurred first). [12]

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