{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:02:19Z","timestamp":1790402539334,"version":"4.1.0"},"reference-count":111,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2016,4,6]]},"abstract":"<jats:p>\u27a4 Propionibacterium is a slow-growing gram-positive rod that is part of the normal skin microbiome but can be found on culture of specimens from a large number of patients having revision shoulder arthroplasty performed for pain, stiffness, and component loosening.<\/jats:p>\n                  <jats:p>\u27a4 Propionibacterium infections do not present with obvious signs of infection, such as swelling, erythema, drainage, or tenderness, but rather are of the so-called stealth type, presenting with unexplained pain, stiffness, or component loosening months to years after the index arthroplasty.<\/jats:p>\n                  <jats:p>\u27a4 Not all propionibacteria are the same: certain subtypes of Propionibacterium are enriched with virulence factors that may enhance deep infection.<\/jats:p>\n                  <jats:p>\u27a4 Because propionibacteria typically reside in the pilosebaceous glands of the oily skin of the chest and back, standard surgical skin preparation solutions and even perioperative intravenous antibiotics are often inadequate at sterilizing the incision site; therefore, other prophylactic measures such as meticulous implant handling to avoid contact with dermal structures need to be considered.<\/jats:p>\n                  <jats:p>\u27a4 Recovery of Propionibacterium from the surgical wounds requires that multiple specimens for culture be taken from different areas of the shoulder to reduce sampling error, and cultures should be held for two weeks on multiple culture media.<\/jats:p>\n                  <jats:p>\u27a4 Future research efforts can be focused on reducing the risk of implant infection and point-of-care methods for identifying Propionibacterium infections.<\/jats:p>","DOI":"10.2106\/jbjs.15.00568","type":"journal-article","created":{"date-parts":[[2016,4,6]],"date-time":"2016-04-06T15:47:55Z","timestamp":1459957675000},"page":"597-606","source":"Crossref","is-referenced-by-count":109,"title":["Propionibacterium in Shoulder Arthroplasty"],"prefix":"10.2106","volume":"98","author":[{"given":"Jason E.","family":"Hsu","sequence":"first","affiliation":[{"name":"Departments of Orthopaedics and Sports Medicine (J.E.H and F.A.M.) and Microbiology (R.E.B.), University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger E.","family":"Bumgarner","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedics and Sports Medicine (J.E.H and F.A.M.) and Microbiology (R.E.B.), University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick A.","family":"Matsen","sequence":"additional","affiliation":[{"name":"Departments of Orthopaedics and Sports Medicine (J.E.H and F.A.M.) and Microbiology (R.E.B.), University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"12","key":"bib1-20230714","first-page":"1212","article-title":"[Propionibacterium acnes infective endocarditis. 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