Prevalence of Propionibacterium acnes in Intervertebral Discs
of Patients Undergoing Lumbar Microdiscectomy: A Prospective
Cross-Sectional Study

J 2016

Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study

CAPOOR, Manu N., Filip RŮŽIČKA, Táňa MACHÁČKOVÁ, Radim JANČÁLEK, Martin SMRČKA et. al.

Basic information

Original name

Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study

Authors

CAPOOR, Manu N. (840 United States of America), Filip RŮŽIČKA (203 Czech Republic, belonging to the institution), Táňa MACHÁČKOVÁ (203 Czech Republic, belonging to the institution), Radim JANČÁLEK (203 Czech Republic, belonging to the institution), Martin SMRČKA (203 Czech Republic, belonging to the institution), Jonathan E. SCHMITZ (840 United States of America), Markéta HERMANOVÁ (203 Czech Republic, belonging to the institution), Jiří ŠÁNA (203 Czech Republic, belonging to the institution), Elleni PONECHAL MICHU (203 Czech Republic, belonging to the institution), John C. BAIRD (203 Czech Republic), Fahad S. AHMED (203 Czech Republic), Karel MÁCA (203 Czech Republic, belonging to the institution), Radim LIPINA (203 Czech Republic), Todd F. ALAMIN (840 United States of America), Michael F. COSCIA (840 United States of America), Jerry L. STONEMETZ (840 United States of America), Timothy WITHAM (840 United States of America), Garth D. EHRLICH (840 United States of America), Ziya L. GOKASLAN (840 United States of America), Konstantinos MAVROMMATIS (840 United States of America), Christof BIRKENMAIER (276 Germany), Vincent A. FISCHETTI (840 United States of America) and Ondřej SLABÝ (203 Czech Republic, guarantor, belonging to the institution)

Edition

Plos one, San Francisco, Public Library of Science, 2016, 1932-6203

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 2.806

RIV identification code

RIV/00216224:14110/16:00091845

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1371/journal.pone.0161676

UT WoS

000381577000130

Keywords in English

BACTERIAL-INFECTION; BIOFILM FORMATION; SKIN; ASSOCIATION; CONTAMINATION; DEGENERATION; SARCOIDOSIS; SCIATICA; SURGERY; SAMPLES

Abstract

V originále

Background 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. Methods and Findings 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 (>= 1x10(3) 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). Conclusions 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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Citovat

CAPOOR, Manu N., Filip RŮŽIČKA, Táňa MACHÁČKOVÁ, Radim JANČÁLEK, Martin SMRČKA, Jonathan E. SCHMITZ, Markéta HERMANOVÁ, Jiří ŠÁNA, Elleni PONECHAL MICHU, John C. BAIRD, Fahad S. AHMED, Karel MÁCA, Radim LIPINA, Todd F. ALAMIN, Michael F. COSCIA, Jerry L. STONEMETZ, Timothy WITHAM, Garth D. EHRLICH, Ziya L. GOKASLAN, Konstantinos MAVROMMATIS, Christof BIRKENMAIER, Vincent A. FISCHETTI and Ondřej SLABÝ. Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study. Plos one. San Francisco: Public Library of Science, 2016, vol. 11, No 8, p. 1-12. ISSN 1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0161676.

@article{1361474,
   author = {Capoor, Manu N. and Růžička, Filip and Macháčková, Táňa and Jančálek, Radim and Smrčka, Martin and Schmitz, Jonathan E. and Hermanová, Markéta and Šána, Jiří and Ponechal Michu, Elleni and Baird, John C. and Ahmed, Fahad S. and Máca, Karel and Lipina, Radim and Alamin, Todd F. and Coscia, Michael F. and Stonemetz, Jerry L. and Witham, Timothy and Ehrlich, Garth D. and Gokaslan, Ziya L. and Mavrommatis, Konstantinos and Birkenmaier, Christof and Fischetti, Vincent A. and Slabý, Ondřej},
   article_location = {San Francisco},
   article_number = {8},
   doi = {http://dx.doi.org/10.1371/journal.pone.0161676},
   keywords = {BACTERIAL-INFECTION; BIOFILM FORMATION; SKIN; ASSOCIATION; CONTAMINATION; DEGENERATION; SARCOIDOSIS; SCIATICA; SURGERY; SAMPLES},
   language = {eng},
   issn = {1932-6203},
   journal = {Plos one},
   title = {Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study},
   volume = {11},
   year = {2016}
}

TY  - JOUR
ID  - 1361474
AU  - Capoor, Manu N. - Růžička, Filip - Macháčková, Táňa - Jančálek, Radim - Smrčka, Martin - Schmitz, Jonathan E. - Hermanová, Markéta - Šána, Jiří - Ponechal Michu, Elleni - Baird, John C. - Ahmed, Fahad S. - Máca, Karel - Lipina, Radim - Alamin, Todd F. - Coscia, Michael F. - Stonemetz, Jerry L. - Witham, Timothy - Ehrlich, Garth D. - Gokaslan, Ziya L. - Mavrommatis, Konstantinos - Birkenmaier, Christof - Fischetti, Vincent A. - Slabý, Ondřej
PY  - 2016
TI  - Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study
JF  - Plos one
VL  - 11
IS  - 8
SP  - 1-12
EP  - 1-12
PB  - Public Library of Science
SN  - 19326203
KW  - BACTERIAL-INFECTION
KW  - BIOFILM FORMATION
KW  - SKIN
KW  - ASSOCIATION
KW  - CONTAMINATION
KW  - DEGENERATION
KW  - SARCOIDOSIS
KW  - SCIATICA
KW  - SURGERY
KW  - SAMPLES
N2  - Background 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. Methods and Findings 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 (>= 1x10(3) 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). Conclusions 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.
ER  -

CAPOOR, Manu N., Filip RŮŽIČKA, Táňa MACHÁČKOVÁ, Radim JANČÁLEK, Martin SMRČKA, Jonathan E. SCHMITZ, Markéta HERMANOVÁ, Jiří ŠÁNA, Elleni PONECHAL MICHU, John C. BAIRD, Fahad S. AHMED, Karel MÁCA, Radim LIPINA, Todd F. ALAMIN, Michael F. COSCIA, Jerry L. STONEMETZ, Timothy WITHAM, Garth D. EHRLICH, Ziya L. GOKASLAN, Konstantinos MAVROMMATIS, Christof BIRKENMAIER, Vincent A. FISCHETTI and Ondřej SLABÝ. Prevalence of Propionibacterium acnes in Intervertebral Discs of Patients Undergoing Lumbar Microdiscectomy: A Prospective Cross-Sectional Study. \textit{Plos one}. San Francisco: Public Library of Science, 2016, vol.~11, No~8, p.~1-12. ISSN~1932-6203. Available from: https://dx.doi.org/10.1371/journal.pone.0161676.

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