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Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection


Böni, Laura; Kuster, Stefan P; Bartik, Bianka; Zbinden, Reinhard; Zingg, Patrick O; Achermann, Yvonne (2018). Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection. Clinical Infectious Diseases, 67(12):1878-1882.

Abstract

Background An increase in the incidence of hip periprosthetic joint infections (PJIs) caused by Cutibacterium avidum has recently been detected after implantation of hip arthroplasties with an anterior surgical approach. We raised the question of whether skin colonization with C. avidum differs between the anterior and the lateral thigh as areas of surgical incision fields.
Methods Between February and June 2017, we analyzed skin scrapings from the groin and the anterior and lateral thigh in all patients undergoing a primary hip arthroplasty. We anaerobically cultured plated swabs for Cutibacterium spp. for at least 7 days. Univariate logistic regression analysis was used to explore associations between body mass index (BMI) and colonization rate at different sites.
Results Twenty-one of 65 patients (32.3%) were colonized with C. avidum at any side, mainly at the groin (n=16, 24.6%), which was significantly higher than at the anterior (n=5, 7.7%, P= 0.009) or lateral (n=6, 9.2%) thigh (P=0.019). Patients colonized with C. avidum did not differ in age or sex compared to non-colonized patients, but BMI was significantly higher (30.1 kg/m2 and 25.6 kg/m2, respectively, P=0.019). Furthermore, increased BMI was associated with colonization at the groin (odds ratio per unit BMI increase: 1.15, 95% confidence interval: 1.03-1.29, P=0.014).
Conclusions The groin, rather than the anterior thigh, showed colonization for C. avidum in obese patients. Further studies are needed to evaluate current skin disinfection and draping protocols for hip arthroplasty surgeries, in particular in obese patients.

Abstract

Background An increase in the incidence of hip periprosthetic joint infections (PJIs) caused by Cutibacterium avidum has recently been detected after implantation of hip arthroplasties with an anterior surgical approach. We raised the question of whether skin colonization with C. avidum differs between the anterior and the lateral thigh as areas of surgical incision fields.
Methods Between February and June 2017, we analyzed skin scrapings from the groin and the anterior and lateral thigh in all patients undergoing a primary hip arthroplasty. We anaerobically cultured plated swabs for Cutibacterium spp. for at least 7 days. Univariate logistic regression analysis was used to explore associations between body mass index (BMI) and colonization rate at different sites.
Results Twenty-one of 65 patients (32.3%) were colonized with C. avidum at any side, mainly at the groin (n=16, 24.6%), which was significantly higher than at the anterior (n=5, 7.7%, P= 0.009) or lateral (n=6, 9.2%) thigh (P=0.019). Patients colonized with C. avidum did not differ in age or sex compared to non-colonized patients, but BMI was significantly higher (30.1 kg/m2 and 25.6 kg/m2, respectively, P=0.019). Furthermore, increased BMI was associated with colonization at the groin (odds ratio per unit BMI increase: 1.15, 95% confidence interval: 1.03-1.29, P=0.014).
Conclusions The groin, rather than the anterior thigh, showed colonization for C. avidum in obese patients. Further studies are needed to evaluate current skin disinfection and draping protocols for hip arthroplasty surgeries, in particular in obese patients.

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Other titles:Working Title : Cutibacterium avidum Colonization in the Groin is Associated with Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection (PJI)
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
04 Faculty of Medicine > Institute of Medical Microbiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:28 November 2018
Deposited On:16 May 2018 13:29
Last Modified:24 Sep 2019 23:29
Publisher:Oxford University Press
ISSN:1058-4838
Additional Information:This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Clinical Infectious Diseases following peer review. The definitive publisher-authenticated version Böni, Laura; Kuster, Stefan P; Bartik, Bianka; Zbinden, Reinhard; Zingg, Patrick O; Achermann, Yvonne (2018). Association of Cutibacterium avidum Colonization in the Groin With Obesity: A Potential Risk Factor for Hip Periprosthetic Joint Infection. Clinical Infectious Diseases, 67(12):1878-1882. is available online at: https://doi.org/10.1093/cid/ciy379
OA Status:Green
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1093/cid/ciy379
PubMed ID:29746626

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