Propionibacteria are part of the normal flora of human skin and mucosal surfaces. Occasionally, they cause clinically significant infections, particularly in the setting of shoulder surgery, orthopedic hardware, endovascular devices, and cerebrospinal shunts. It can be difficult to determine whether positive culture results for Propionibacteria reflect contamination or true infection.
Infections with Propionibacterium species can be classified into three categories:
- Acne in teenagers and young adults (when caused by P. acnes)
- Surgical wound infections
- Invasive deep seated infections, usually in the setting of implantable devices (eg, pacemakers, shunts, etc)
This card discusses the clinical manifestations, diagnosis, and treatment of invasive Propionibacterium infections in patients with implantable devices. Issues related to acne are discussed in detail separately. (See "Pathogenesis, clinical manifestations, and diagnosis of acne vulgaris" and "Treatment of acne vulgaris".)
MICROBIOLOGY AND PATHOGENESIS
Propionibacteria are normally present on human skin and in sebaceous glands and hair follicles; they can also be recovered from the conjunctiva, external ear, nasopharynx, oral cavity, and genitourinary tract . In addition, P. acnes is a common environmental surface contaminant [2,3]. Therefore, it is often difficult to determine whether positive culture results for Propionibacteria reflect contamination or true infection.