Journal article
Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study
PloS one, v 11(8), pp e0161676-e0161676
2016
PMID: 27536784
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The relationship between intervertebral disc degeneration and chronic infection by Propionibacterium acnes is controversial with contradictory evidence available in the literature. Previous studies investigating these relationships were under-powered and fraught with methodical differences; moreover, they have not taken into consideration P. acnes' ability to form biofilms or attempted to quantitate the bioburden with regard to determining bacterial counts/genome equivalents as criteria to differentiate true infection from contamination. The aim of this prospective cross-sectional study was to determine the prevalence of P. acnes in patients undergoing lumbar disc microdiscectomy.
The sample consisted of 290 adult patients undergoing lumbar microdiscectomy for symptomatic lumbar disc herniation. An intraoperative biopsy and pre-operative clinical data were taken in all cases. One biopsy fragment was homogenized and used for quantitative anaerobic culture and a second was frozen and used for real-time PCR-based quantification of P. acnes genomes. P. acnes was identified in 115 cases (40%), coagulase-negative staphylococci in 31 cases (11%) and alpha-hemolytic streptococci in 8 cases (3%). P. acnes counts ranged from 100 to 9000 CFU/ml with a median of 400 CFU/ml. The prevalence of intervertebral discs with abundant P. acnes (≥ 1x103 CFU/ml) was 11% (39 cases). There was significant correlation between the bacterial counts obtained by culture and the number of P. acnes genomes detected by real-time PCR (r = 0.4363, p<0.0001).
In a large series of patients, the prevalence of discs with abundant P. acnes was 11%. We believe, disc tissue homogenization releases P. acnes from the biofilm so that they can then potentially be cultured, reducing the rate of false-negative cultures. Further, quantification study revealing significant bioburden based on both culture and real-time PCR minimize the likelihood that observed findings are due to contamination and supports the hypothesis P. acnes acts as a pathogen in these cases of degenerative disc disease.
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Details
- Title
- Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study
- Creators
- Manu N Capoor - Department of Molecular Oncology, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech RepublicFilip Ruzicka - Department of Microbiology, Faculty of Medicine, Masaryk university, St. Anne's Faculty Hospital, Brno, Czech RepublicTana Machackova - Department of Molecular Oncology, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech RepublicRadim Jancalek - Department of Neurosurgery, St. Anne's University Hospital, Masaryk University, Brno, Czech RepublicMartin Smrcka - Department of Neurosurgery, University Hospital Brno, Masaryk University, Brno, Czech RepublicJonathan E Schmitz - Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN, United States of AmericaMarketa Hermanova - 1st Department of Pathological Anatomy, St. Anne's University Hospital, Masaryk University, Brno, Czech RepublicJiri Sana - Department of Molecular Oncology, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech RepublicElleni Michu - Department of Molecular Oncology, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech RepublicJohn C Baird - Department of Molecular Oncology, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech RepublicFahad S Ahmed - Department of Molecular Oncology, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech RepublicKarel Maca - Department of Neurosurgery, University Hospital Brno, Masaryk University, Brno, Czech RepublicRadim Lipina - Department of Neurosurgery, University Hospital Ostrava, Ostrava University, Ostrava, Czech RepublicTodd F Alamin - Department of Orthopedic Surgery, Stanford University Medical Center, Stanford University, Stanford, CA, United States of AmericaMichael F Coscia - Department of Orthopedic Surgery, OrthoIndy Hospital, Indianapolis, IN, United States of AmericaJerry L Stonemetz - Department of Anesthesia, The Johns Hopkins Hospital, Baltimore, MD, United States of AmericaTimothy Witham - Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, MD, United States of AmericaGarth D Ehrlich - Department of Otolaryngology Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States of America, and Institute of Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA, United States of AmericaZiya L Gokaslan - Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, RI, United States of AmericaKonstantinos Mavrommatis - Celgene Corporation, Information Knowledge and Utilization, San Francisco, CA, United States of AmericaChristof Birkenmaier - Department of Orthopedics, Physical Medicine & Rehabilitation, University of Munich (LMU), Munich, GermanyVincent A Fischetti - Laboratory of Bacterial Pathogenesis and Immunology, Rockefeller University, New York, NY, United States of AmericaOndrej Slaby - Department of Molecular Oncology, Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
- Publication Details
- PloS one, v 11(8), pp e0161676-e0161676
- Publisher
- Public LIbrary of Science (PLOS); United States
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Microbiology and Immunology
- Web of Science ID
- WOS:000381577000130
- Scopus ID
- 2-s2.0-84984796503
- Other Identifier
- 991014969752304721
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Orthopedics