Defeating the Hidden Foe: Antibiotic Therapy and Clinical Outcomes of Cutibacterium acnes Spinal Implant Infections

Don Bambino Geno Tai, Brian Lahr, Gina A. Suh, Elie F. Berbari, Paul M. Huddleston, Aaron J. Tande

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Cutibacterium acnes can cause spinal implant infections. However, little is known about the optimal medical management and outcomes of C. acnes spinal implant infections (CSII). Our study aims to describe the management of patients with CSII and evaluate the clinical outcomes. Methods: We performed a retrospective cohort study of patients aged 18 years or older who underwent spinal fusion surgery with instrumentation between January 1, 2011, and December 31, 2020, and whose intraoperative cultures were positive for C. acnes. The primary outcome was treatment failure based on subsequent recurrence, infection with another organism, or unplanned surgery secondary to infection. Results: There were 55 patients with a median follow-up (interquartile range) of 2 (1.2-2.0) years. Overall, there were 6 treatment failures over 85.8 total person-years, for an annual rate of 7.0% (95% CI, 2.6%-15.2%). Systemic antibiotic treatment was given to 74.5% (n = 41) of patients for a median duration of 352 days. In the subgroup treated with systemic antibiotics, there were 4 treatment failures (annual rate, 6.3%; 95% CI, 1.7%-16.2%), all of which occurred while on antibiotic therapy. Two failures occurred in the subgroup without antibiotic treatment (annual rate, 8.8%; 95% CI, 1.1%-31.8%). Conclusions: Our study found that the estimated annual treatment failure rate was slightly higher among patients who did not receive antibiotics. Of the 6 failures observed, 4 had recurrence of C. acnes either on initial or subsequent treatment failures. More studies are warranted to determine the optimal duration of therapy for CSII.

Original languageEnglish (US)
Article numberofad403
JournalOpen Forum Infectious Diseases
Volume10
Issue number8
DOIs
StatePublished - Aug 2023

Bibliographical note

Funding Information:
Financial support. This project was partly funded by Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences.

Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.

Keywords

  • antibiotic therapy
  • Cutibacterium acnes
  • spinal implant infection
  • spine surgery complications
  • surgical site infections

PubMed: MeSH publication types

  • Journal Article

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