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However, there is a paucity of literature examining the pathogenesis of\n                    <jats:italic>C. acnes<\/jats:italic>\n                    during PJI. To study this, we developed an implant\u2010associated osteomyelitis murine model in which 8\u201310\u2010week\u2010old C57BL6 mice were subjected to transtibial implantation of titanium or stainless\u2010steel L\u2010shaped pins contaminated with\n                    <jats:italic>C. acnes<\/jats:italic>\n                    . Postsurgery, mice were killed on Days 14 and 28 for terminal assessments of (1) bacterial load in bone, implant, and internal organs (heart, spleen, kidney, and liver), (2) bone osteolysis (micro\u2010CT), (3) abscess formation (histology), and (4) systematic electron microscopy (EM). In vitro scanning EM (SEM) confirmed that\n                    <jats:italic>C. acnes<\/jats:italic>\n                    can form biofilms on stainless\u2010steel and titanium implants. In mice,\n                    <jats:italic>C. acnes<\/jats:italic>\n                    could persist for 28 days in the tibia. Also, we observed\n                    <jats:italic>C. acnes<\/jats:italic>\n                    dissemination to internal organs.\n                    <jats:italic>C. acnes<\/jats:italic>\n                    chronic osteomyelitis revealed markedly reduced bone osteolysis and abscess formation compared to\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    infections. Importantly, transmission EM (TEM) investigation revealed the presence of\n                    <jats:italic>C. acnes<\/jats:italic>\n                    within canaliculi, demonstrating that\n                    <jats:italic>C. acnes<\/jats:italic>\n                    can invade the osteocyte lacuno\u2010canalicular networks (OLCN) within bone\n                    <jats:italic>.<\/jats:italic>\n                    Our preliminary pilot study, for the first time, revealed that the OLCN in bone can be a reservoir for\n                    <jats:italic>C. acnes<\/jats:italic>\n                    and potentially provides a novel mechanism of why\n                    <jats:italic>C. acnes<\/jats:italic>\n                    chronic implant\u2010associated bone infections are difficult to treat.\n                  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