Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Canadian Centre for Human Microbiome and Probiotics, Lawson Health Research Institute, London, ON, Canada.
J Shoulder Elbow Surg. 2018 Oct;27(10):1734-1739. doi: 10.1016/j.jse.2018.04.019. Epub 2018 Jun 13.
Advances in DNA sequencing technologies have made it possible to detect microbial genome sequences (microbiomes) within tissues once thought to be sterile. We used this approach to gain insights into the likely sources of Cutibacterium acnes (formerly Propionibacterium acnes) infections within the shoulder.
Tissue samples were collected from the skin, subcutaneous fat, anterior supraspinatus tendon, middle glenohumeral ligament, and humeral head cartilage of 23 patients (14 male and 9 female patients) during primary arthroplasty surgery. Total DNA was extracted and microbial 16S ribosomal RNA sequencing was performed using an Illumina MiSeq system. Data analysis software was used to generate operational taxonomic units for quantitative and statistical analyses.
After stringent removal of contamination, genomic DNA from various Acinetobacter species and from the Oxalobacteraceae family was identified in 74% of rotator cuff tendon tissue samples. C acnes DNA was detected in the skin of 1 male patient but not in any other shoulder tissues.
Our findings indicate the presence of a low-abundance microbiome in the rotator cuff and, potentially, in other shoulder tissues. The absence of C acnes DNA in all shoulder tissues assessed other than the skin is consistent with the hypothesis that C acnes infections are derived from skin contamination during surgery and not from opportunistic expansion of a resident C acnes population in the shoulder joint.
DNA 测序技术的进步使得人们能够检测到曾经被认为无菌的组织内的微生物基因组序列（微生物组）。我们采用这种方法来深入了解肩内痤疮丙酸杆菌（以前称为丙酸杆菌）感染的可能来源。
在初次关节置换手术期间，从 23 名患者（14 名男性和 9 名女性）的皮肤、皮下脂肪、前肩袖肌腱、中盂肱韧带和肱骨头软骨中采集组织样本。提取总 DNA 并使用 Illumina MiSeq 系统进行微生物 16S 核糖体 RNA 测序。数据分析软件用于生成操作分类单元，以进行定量和统计分析。
经过严格去除污染后，在 74%的肩袖肌腱组织样本中鉴定出各种不动杆菌属和 Oxalobacteraceae 家族的基因组 DNA。在 1 名男性患者的皮肤中检测到 C 痤疮丙酸杆菌 DNA，但在其他任何肩部组织中均未检测到。
我们的研究结果表明，肩袖和其他肩部组织中存在低丰度微生物组。除皮肤外，所有评估的肩部组织中均未检测到 C 痤疮丙酸杆菌 DNA，这与 C 痤疮丙酸杆菌感染源自手术期间皮肤污染而不是来自肩部关节内常驻 C 痤疮丙酸杆菌种群的机会性扩张的假设一致。
