Correlation between hemolytic profile and phylotype of Cutibacterium acnes (formerly Propionibacterium acnes) and orthopedic implant infection

Julia Lee, Kerryl E. Greenwood Quaintance, Audrey N. Schuetz, Dave R. Shukla, Robert H. Cofield, John W. Sperling, Robin Patel, Joaquin Sanchez-Sotelo

Research output: Contribution to journalArticlepeer-review


Introduction: Cutibacterium acnes is a recognized culprit for implant-associated infections, but positive cultures do not always indicate clinically relevant infection. Studies have shown a correlation between the β-hemolytic phenotype of C. acnes and its infectious capacity, but correlation with genetic phylotype has not been performed in literature. The purpose of this study is to evaluate β-hemolysis phenotype, genetic phylotype, and mid-term clinical outcomes of C. acnes isolated from orthopedic surgical sites. Methods: Fifty-four C. acnes isolates previously obtained from surgical wounds of patients undergoing hip, knee, shoulder, or spine implant removal were re-cultured. There were 21 females and 33 males with an average age of 59 years (range, 18–84). Twenty-four were from clinically infected sites whereas 30 were considered contaminants. De novo β-hemolysis was analyzed and a retrospective chart review was performed to evaluate clinical outcomes at 7.1 years (range, 0.1–12.8). Results: On Brucella agar with 5% rabbit blood, 46% of contaminant and 43% of infectious isolates were hemolytic. Type II phylotype was significantly more nonhemolytic regardless of infectious or contaminant status (p < 0.05). Type 1B correlated with a hemolytic-infectious phenotype and Type 1A with a hemolytic-contaminant phenotype but was not statistically significant. Conclusion: The β-hemolytic profile of C. acnes did not correlate with phylotype or clinically relevant orthopedic infection.

Original languageEnglish (US)
Pages (from-to)390-398
Number of pages9
JournalShoulder and Elbow
Issue number6
StatePublished - Dec 2020


  • Cutibacterium acnes
  • Propionibacterium acnes
  • hemolytic phenotype
  • infection
  • periprosthetic joint infection
  • phylotype

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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