Kyung Hee University Hospital, Seoul, Republic of Korea.
Myongji Hospital, Goyang-si, Republic of Korea.
J Shoulder Elbow Surg. 2020 Oct;29(10):2036-2042. doi: 10.1016/j.jse.2020.02.015. Epub 2020 May 22.
Most studies on Cutibacterium acnes in shoulder surgery have been conducted in the Western population, and studies on Asians are rare. We evaluated the incidence and risk factors of C acnes in shoulder arthroplasty in Asians.
We retrospectively analyzed 154 patients between January 2017 and May 2019 who underwent shoulder arthroplasty. Swabs were taken after skin preparation from the skin surface of the anterior acromion, axilla, and joint fluid to study the incidence of C acnes. Before skin preparation we also collected swabs from the anterior acromion, axilla, and thigh from 59 of the 154 patients.
Eight of 154 patients after and 6 of 59 patients before skin preparation were positive for C acnes. C acnes were found in 2 patients at the anterior acromion and in 6 at the synovial joint after skin preparation and in 1 patient at the axilla, in 5 at the anterior acromion, and in 3 at the thigh before preparation. History of steroid injection and number of steroid injections were significantly associated with C acnes isolation (P = .039 and P = .006, respectively), whereas age, sex, body mass index, shoulder surgery history, hypertension, diabetes, and cerebrovascular disease were not, as were serum inflammatory markers, including white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate.
A total of 5.2% of the patients after skin preparation and 10.2% of patients before skin preparation were found to be positive for C acnes. The incidence of C acnes in patients who underwent shoulder arthroplasties in Asia was low and, thus, ethnic differences should be considered for C acnes. The history and number of steroid injections were associated with isolation of C acnes.
大多数关于痤疮丙酸杆菌在肩部手术中的研究都是在西方人群中进行的，而亚洲人的研究很少。我们评估了亚洲人肩关节置换术中痤疮丙酸杆菌的发生率和危险因素。
我们回顾性分析了 2017 年 1 月至 2019 年 5 月期间 154 例接受肩关节置换术的患者。在皮肤准备后，从肩峰前表面、腋窝和关节液中采集拭子，以研究痤疮丙酸杆菌的发生率。在皮肤准备前，我们还从 154 例患者中的 59 例采集了肩峰前、腋窝和大腿的拭子。
154 例患者中有 8 例（5.2%）和 59 例患者中有 6 例（10.2%）在皮肤准备前为痤疮丙酸杆菌阳性。在皮肤准备后，有 2 例在前肩峰和 6 例在关节滑液中发现痤疮丙酸杆菌，有 1 例在腋窝，有 5 例在前肩峰，有 3 例在大腿准备前发现痤疮丙酸杆菌。类固醇注射史和类固醇注射次数与痤疮丙酸杆菌分离显著相关（P=0.039 和 P=0.006），而年龄、性别、体重指数、肩关节手术史、高血压、糖尿病和脑血管疾病以及包括白细胞计数、C 反应蛋白水平和红细胞沉降率在内的血清炎症标志物则不然。
皮肤准备后有 5.2%的患者和皮肤准备前有 10.2%的患者被发现为痤疮丙酸杆菌阳性。亚洲人肩关节置换术患者中痤疮丙酸杆菌的发生率较低，因此应考虑种族差异。类固醇注射史和类固醇注射次数与痤疮丙酸杆菌的分离有关。
