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European Spine Journal
Published in: European Spine Journal 7/2020

01-07-2020 | Scoliosis | Original Article

Is Cutibacterium acnes early surgical site infection rate related to the duration of antibiotic prophylaxis in adolescent idiopathic scoliosis surgery?

Authors: Marion Caseris, Brice Ilharreborde, Catherine Doit, Anne-Laure Simon, Christine Vitoux, Nora Poey, Stéphane Bonacorsi, Cindy Mallet

Published in: European Spine Journal | Issue 7/2020

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Abstract

Purpose

Cutibacterium acnes (C. acnes) is a gram-positive anaerobic bacillus located in pilosebaceous glands, usually responsible for late postoperative surgical site infections (SSI). A recent study performed in our institution highlighted an unexpected emergence of C. acnes early SSI. One potential explanation was the change of the perioperative antibioprophylaxis (ATB) protocol, which switched from 48 h postoperative cefamandole to intraoperative only cefazoline. The aim of this study was therefore to investigate the influence of the ATB duration on the occurrence of C. acnes early SSI, by comparing the incidence rates during 3 consecutive ATB protocols.

Methods

Between January 2007 and September 2017, all patients who underwent posterior fusion for AIS were retrospectively reviewed. Early C. acnes SSI were reported and compared between 3 periods, during which the ATB protocols were modified.
  • January 2007–February 2012: Intraoperative Cefamandole continued 48 h (protocol 1)
  • March 2012–August 2016: Single shot of intraoperative Cefazoline (protocol 2)
  • September 2016–September 2017: Intraoperative Cefazoline continued 48 h (protocol 3).

Results

Fifty-three early SSI (7.2%) were reported among the 732 posterior AIS fusions included. Global incidence of C. acnes infection was 2.9%. The incidence of C. acnes in early SSI increased from 0 to 4.9% between protocol 1 and 2, but was reduced to 1.7% with protocol 3.

Conclusions

Early C acnes SSI can be explained by the difficulty to eradicate this pathogen with current skin preparation procedures and some Beta-lactam antibiotics tolerance. Longer duration antibioprophylaxis is preferable to prevent from early C. acnes SSI.
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Metadata
Title
Is Cutibacterium acnes early surgical site infection rate related to the duration of antibiotic prophylaxis in adolescent idiopathic scoliosis surgery?
Authors
Marion Caseris
Brice Ilharreborde
Catherine Doit
Anne-Laure Simon
Christine Vitoux
Nora Poey
Stéphane Bonacorsi
Cindy Mallet
Publication date
01-07-2020
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 7/2020
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-020-06427-2

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Author's Reply

Answer to the Letter to the Editor of Tamburrelli FC et al., concerning “Prone single-position extreme lateral interbody fusion (Pro-XLIF): preliminary results” by Lamartina C and Berjano P (Eur Spine J; 2020: https://doi.org/10.1007/s00586-020-06303-z)

Author's reply

Answer to the letter to the editor of V. Kumar et al. concerning “influence of body position and axial load on spinal stiffness in healthy young adults” by Häusler M, et al. (Eur Spine J; [2020]: DOI:10.1007/S00586-019–06254-0)