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lüll Propionibacterium acnes: an under-appreciated cause of post-neurosurgical infection Nisbet M; Briggs S; Ellis-Pegler R; Thomas M; Holland DJ Antimicrob Chemother 2007[Nov]; 60 (5): 1097-103BACKGROUND: Propionibacterium acnes is increasingly recognized as a cause of post-neurosurgical infection. This review of patients with P. acnes neurosurgical infection was carried out in order to determine clinical characteristics and outcomes in relation to duration of antimicrobial treatment. METHODS: We retrospectively reviewed the charts of consecutive patients with P. acnes isolated from neurosurgical specimens from 1 January 1999 to 30 June 2005. We defined P. acnes neurosurgical infection as isolation of P. acnes alone from a sterile neurosurgical site in a patient who clinically improved following treatment with an appropriate antibiotic. RESULTS: We identified 28 patients with definite P. acnes neurosurgical infection; median age 49 years (range 23-77); 15 (54%) male. All patients had prior neurosurgical procedures: 27 (96%) post-craniotomy. The median time from surgery to presentation was 54 days (range 12-1,578). Eighteen out of 28 (64%) patients who met the definition of neurosurgical infection had Gram-positive bacilli seen in at least one surgical specimen compared with only 2/56 (4%) patients who did not meet the definition (P < 0.0001). Intravenous benzyl penicillin +/- oral penicillin VK was the most common treatment. The median duration of antibiotic treatment for intracranial infection was 29 days. Five of nine patients who had extracranial bone-flap-associated infection had |Adult[MESH]|Aged[MESH]|Anti-Bacterial Agents/therapeutic use[MESH]|Female[MESH]|Gram-Positive Bacterial Infections/diagnosis/drug therapy/*microbiology[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Neurosurgical Procedures/*adverse effects[MESH]|Osteomyelitis/drug therapy/microbiology[MESH]|Postoperative Complications/diagnosis/drug therapy/*microbiology[MESH]|Propionibacterium acnes/*isolation & purification/physiology[MESH]|Retrospective Studies[MESH]|Surgical Wound Infection/diagnosis/drug therapy/*microbiology[MESH] |