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The purpose of the present study was to report the treatment outcomes of patients with <jats:italic>C. acnes<\/jats:italic> contamination or infection in the presence of a TJR treated with a revision surgery\u2009\u00b1\u2009implant exchange\u2009\u00b1\u2009prolonged (\u2265\u20098\u00a0weeks) postoperative antibiotics.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Medical records of patients with at least one positive <jats:italic>C. acnes<\/jats:italic> culture in intraoperative tissue samples or sonication fluid from a TJR revision surgery between January 2005 and December 2014 were retrospectively evaluated. The primary endpoint was infection eradication according to Delphi criteria. The diagnostic accuracy of preoperative TJR aspiration regarding the diagnosis of <jats:italic>C. acnes<\/jats:italic> PJI was also investigated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 52 TJR (28 shoulders, 17 hips, 7 knees) in 52 patients (35 males, 17 females) with an average age of 63\u2009\u00b1\u200911 (33\u201386) years were included. At an average follow-up of 67\u2009\u00b1\u200933 (24\u2013127)\u00a0months, the infection eradication of <jats:italic>C. acnes<\/jats:italic> PJI was 97% regardless of the surgical treatment or administration of prolonged postoperative antibiotics. The incidence of unsuspected <jats:italic>C. acnes<\/jats:italic> PJI was 28.8%. The sensitivity and specificity of preoperative joint aspiration in detecting <jats:italic>C. acnes<\/jats:italic> PJI were 59% and 88%, whereas the PPV and NNV were 83% and 67%, respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Infection eradication of <jats:italic>C. acnes<\/jats:italic> PJI was very high at a minimum follow-up of 24\u00a0months, suggesting that <jats:italic>C. acnes<\/jats:italic> PJI could be adequately treated with a combination of revision surgery and prolonged postoperative antibiotics. The preoperative diagnosis of <jats:italic>C. acnes<\/jats:italic> PJI might be challenging with more than one-quarter of patients presenting without suspicion of <jats:italic>C. acnes<\/jats:italic> PJI. The appropriate treatment of patients with a single positive culture remains still unclear. A negative TJR aspiration should not rule out a <jats:italic>C. acnes<\/jats:italic> PJI, especially in the presence of clinical correlates of infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Level of evidence<\/jats:title>\n                <jats:p>Retrospective case\u2013control study, Level III.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>IRB approval<\/jats:title>\n                <jats:p>Kantonale Ethikkommission Z\u00fcrich, BASEC Nr.:2017-00567.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00402-022-04489-z","type":"journal-article","created":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T15:02:43Z","timestamp":1656342163000},"page":"2951-2958","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Treatment outcomes of patients with Cutibacterium acnes-positive cultures during total joint replacement revision surgery: a minimum 2-year follow-up"],"prefix":"10.1007","volume":"143","author":[{"given":"A.","family":"Hoch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Fritz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-7080","authenticated-orcid":false,"given":"D.","family":"Dimitriou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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