Cutibacterium Dermal Colonization: Implications for Total Hip Arthroplasty
NCT ID: NCT03849885
Last Updated: 2023-01-10
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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UNKNOWN
PHASE4
496 participants
INTERVENTIONAL
2019-02-02
2024-12-31
Brief Summary
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Detailed Description
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Conditions
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Study Design
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RANDOMIZED
PARALLEL
DIAGNOSTIC
NONE
Study Groups
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Standard Skin Prep
Patients will undergo a skin cleansing protocols using 4% Chlorhexidine gluconate (CHG) cloths.
After the skin prep, three 3-mm punch (Acu-Punch, Acuderm, Fort Lauderdale, FL) skin biopsies will performed for both an anterior-based hypothetical incision, and for a more lateral/posterior incision, for a total of 6 biopsies taken per subject.
No interventions assigned to this group
Experimental Skin Prep with BPO
Patients will undergo a skin cleansing protocols using 4% Chlorhexidine gluconate (CHG) cloths.
Following the CHG wipes, patients will be prepped with 5% BPO gel applied directly to the biopsy site.
After the skin prep, three 3-mm punch (Acu-Punch, Acuderm, Fort Lauderdale, FL) skin biopsies will performed for both an anterior-based hypothetical incision, and for a more lateral/posterior incision, for a total of 6 biopsies taken per subject.
Benzoyl peroxide gel
Skin prep with Chlorohexidine wipes and BPO.
Interventions
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Benzoyl peroxide gel
Skin prep with Chlorohexidine wipes and BPO.
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* CJR primary joint arthroplasty patients who are receiving care at Porter Adventist Hospital
* CJR established primary knee or hip arthroplasty patients with a native hip joint (no replacement on the biopsy side) who volunteers as a research participant.
* CJR patients without a previous arthroplasty procedure who have established care with our practice.
Exclusion Criteria
* Current antibiotic use or antibiotic use within the past week
* Previous history of Cutibacterium joint infection
* Current immunodeficiency disease or disorder
* Patients with active psoriatic disease or other focal inflammation over the hip
* Previous total hip arthroplasty (bilateral for the case of TKA patients and healthy volunteers, contralateral for THA patients)
18 Years
85 Years
ALL
Yes
Sponsors
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Colorado Joint Replacement
OTHER
Responsible Party
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Principal Investigators
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Jason M Jennings, MD DPT
Role: PRINCIPAL_INVESTIGATOR
Colorado Joint Replacement
Locations
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Colorado Joint Replacement
Denver, Colorado, United States
Countries
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Central Contacts
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Facility Contacts
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References
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Koh CK, Marsh JP, Drinkovic D, Walker CG, Poon PC. Propionibacterium acnes in primary shoulder arthroplasty: rates of colonization, patient risk factors, and efficacy of perioperative prophylaxis. J Shoulder Elbow Surg. 2016 May;25(5):846-52. doi: 10.1016/j.jse.2015.09.033. Epub 2015 Dec 15.
Kurtz SM, Lau E, Watson H, Schmier JK, Parvizi J. Economic burden of periprosthetic joint infection in the United States. J Arthroplasty. 2012 Sep;27(8 Suppl):61-5.e1. doi: 10.1016/j.arth.2012.02.022. Epub 2012 May 2.
Lavergne V, Malo M, Gaudelli C, Laprade M, Leduc S, Laflamme P, Rouleau DM. Clinical impact of positive Propionibacterium acnes cultures in orthopedic surgery. Orthop Traumatol Surg Res. 2017 Apr;103(2):307-314. doi: 10.1016/j.otsr.2016.12.005. Epub 2017 Jan 5.
Butler-Wu SM, Burns EM, Pottinger PS, Magaret AS, Rakeman JL, Matsen FA 3rd, Cookson BT. Optimization of periprosthetic culture for diagnosis of Propionibacterium acnes prosthetic joint infection. J Clin Microbiol. 2011 Jul;49(7):2490-5. doi: 10.1128/JCM.00450-11. Epub 2011 May 4.
Dizay HH, Lau DG, Nottage WM. Benzoyl peroxide and clindamycin topical skin preparation decreases Propionibacterium acnes colonization in shoulder arthroscopy. J Shoulder Elbow Surg. 2017 Jul;26(7):1190-1195. doi: 10.1016/j.jse.2017.03.003. Epub 2017 May 4.
Heckmann N, Sivasundaram L, Heidari KS, Weber AE, Mayer EN, Omid R, Vangsness CT Jr, Hatch GF 3rd. Propionibacterium Acnes Persists Despite Various Skin Preparation Techniques. Arthroscopy. 2018 Jun;34(6):1786-1789. doi: 10.1016/j.arthro.2018.01.019. Epub 2018 Mar 24.
Heckmann N, Sivasundaram L, Lieberman JR. Propionibacterium acnes Infection in the Native Hip: A Case Report. JBJS Case Connect. 2015 Jul-Sep;5(3):e60. doi: 10.2106/JBJS.CC.N.00192.
Holinka J, Bauer L, Hirschl AM, Graninger W, Windhager R, Presterl E. Sonication cultures of explanted components as an add-on test to routinely conducted microbiological diagnostics improve pathogen detection. J Orthop Res. 2011 Apr;29(4):617-22. doi: 10.1002/jor.21286. Epub 2010 Dec 7.
Hsu JE, Neradilek MB, Russ SM, Matsen FA 3rd. Preoperative skin cultures are predictive of Propionibacterium load in deep cultures obtained at revision shoulder arthroplasty. J Shoulder Elbow Surg. 2018 May;27(5):765-770. doi: 10.1016/j.jse.2018.01.021. Epub 2018 Mar 12.
Hudek R, Sommer F, Kerwat M, Abdelkawi AF, Loos F, Gohlke F. Propionibacterium acnes in shoulder surgery: true infection, contamination, or commensal of the deep tissue? J Shoulder Elbow Surg. 2014 Dec;23(12):1763-1771. doi: 10.1016/j.jse.2014.05.024. Epub 2014 Aug 29.
Lee MJ, Pottinger PS, Butler-Wu S, Bumgarner RE, Russ SM, Matsen FA 3rd. Propionibacterium persists in the skin despite standard surgical preparation. J Bone Joint Surg Am. 2014 Sep 3;96(17):1447-50. doi: 10.2106/JBJS.M.01474.
Levy O, Iyer S, Atoun E, Peter N, Hous N, Cash D, Musa F, Narvani AA. Propionibacterium acnes: an underestimated etiology in the pathogenesis of osteoarthritis? J Shoulder Elbow Surg. 2013 Apr;22(4):505-11. doi: 10.1016/j.jse.2012.07.007. Epub 2012 Sep 13.
MacNiven I, Hsu JE, Neradilek MB, Matsen FA 3rd. Preoperative Skin-Surface Cultures Can Help to Predict the Presence of Propionibacterium in Shoulder Arthroplasty Wounds. JB JS Open Access. 2018 Feb 16;3(1):e0052. doi: 10.2106/JBJS.OA.17.00052. eCollection 2018 Mar 29.
Nelson CL, McLaren AC, McLaren SG, Johnson JW, Smeltzer MS. Is aseptic loosening truly aseptic? Clin Orthop Relat Res. 2005 Aug;(437):25-30. doi: 10.1097/01.blo.0000175715.68624.3d.
Ong KL, Kurtz SM, Lau E, Bozic KJ, Berry DJ, Parvizi J. Prosthetic joint infection risk after total hip arthroplasty in the Medicare population. J Arthroplasty. 2009 Sep;24(6 Suppl):105-9. doi: 10.1016/j.arth.2009.04.027. Epub 2009 Jun 2.
Parvizi J, Erkocak OF, Della Valle CJ. Culture-negative periprosthetic joint infection. J Bone Joint Surg Am. 2014 Mar 5;96(5):430-6. doi: 10.2106/JBJS.L.01793.
Phadnis J, Gordon D, Krishnan J, Bain GI. Frequent isolation of Propionibacterium acnes from the shoulder dermis despite skin preparation and prophylactic antibiotics. J Shoulder Elbow Surg. 2016 Feb;25(2):304-10. doi: 10.1016/j.jse.2015.08.002. Epub 2015 Oct 9.
Portillo ME, Corvec S, Borens O, Trampuz A. Propionibacterium acnes: an underestimated pathogen in implant-associated infections. Biomed Res Int. 2013;2013:804391. doi: 10.1155/2013/804391. Epub 2013 Nov 6.
Sabetta JR, Rana VP, Vadasdi KB, Greene RT, Cunningham JG, Miller SR, Sethi PM. Efficacy of topical benzoyl peroxide on the reduction of Propionibacterium acnes during shoulder surgery. J Shoulder Elbow Surg. 2015 Jul;24(7):995-1004. doi: 10.1016/j.jse.2015.04.003.
Scheer VM, Bergman Jungestrom M, Lerm M, Serrander L, Kalen A. Topical benzoyl peroxide application on the shoulder reduces Propionibacterium acnes: a randomized study. J Shoulder Elbow Surg. 2018 Jun;27(6):957-961. doi: 10.1016/j.jse.2018.02.038. Epub 2018 Mar 30.
Sierra JM, Garcia S, Martinez-Pastor JC, Tomas X, Gallart X, Vila J, Bori G, Macule F, Mensa J, Riba J, Soriano A. Relationship between the degree of osteolysis and cultures obtained by sonication of the prostheses in patients with aseptic loosening of a hip or knee arthroplasty. Arch Orthop Trauma Surg. 2011 Oct;131(10):1357-61. doi: 10.1007/s00402-011-1307-4. Epub 2011 May 11.
Wildeman P, Bruggemann H, Scholz CF, Leimbach A, Soderquist B. Propionibacterium avidum as an Etiological Agent of Prosthetic Hip Joint Infection. PLoS One. 2016 Jun 29;11(6):e0158164. doi: 10.1371/journal.pone.0158164. eCollection 2016.
Zeller V, Ghorbani A, Strady C, Leonard P, Mamoudy P, Desplaces N. Propionibacterium acnes: an agent of prosthetic joint infection and colonization. J Infect. 2007 Aug;55(2):119-24. doi: 10.1016/j.jinf.2007.02.006. Epub 2007 Apr 5.
Zeller VA, Letembet VA, Meyssonnier VA, Heym B, Ziza JM, Marmor SD. Cutibacterium (Formerly Propionibacterium) avidum: A Rare but Avid Agent of Prosthetic Hip Infection. J Arthroplasty. 2018 Jul;33(7):2246-2250. doi: 10.1016/j.arth.2018.02.008. Epub 2018 Feb 12.
Other Identifiers
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1378012
Identifier Type: -
Identifier Source: org_study_id
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