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Propionibacterium acnes isolates usually have relatively low virulence and are often classified as contaminants when isolated from blood and tissue cultures. We report a patient with Propionibacterium acnes bacteremia and late prosthetic valve endocarditis, complicated by an aortic root abscess.
The production of chondroitin sulfatase, hyaluronidase, deoxyribonuclease, gelatinase, phosphatase, lecithinase, and hemolysins was examined in 95 strains of Propionibacterium acnes and four related species of anaerobic, respectively, microaerophilic coryneform bacteria (P. avidum, P. lymphophilum, P. granulosum, and Corynebacterium minutissimum). All enzymes could be demonstrated in at least one representative of the species tested. Those Propionibacterium species most frequently found in acne vulgaris lesions, i.e., P. acnes and P. granulosum, proved to be the most active organisms concerning the production of the enzymes tested. P. avidum, on the other hand, showed the highest rate of hemolytic activity.
The minimum inhibitory concentration (MIC) of acetic and propionic acid for resident bacteria on normal human skin, such as Propionibacterium acnes and Staphylococcus epidermidis, was 25 mg/mL or more at any pH tested (pH 5.5-6.8). While the MIC of these acids for most of the transient bacteria was markedly decreased by lowering the pH of the media and at pH 5.5, the mean pH value of the normal human skin, the MIC was 6.25 mg/mL or less. The MIC of oleic acid for some strains of Gram-positive transient bacteria of Streptococcus, Micrococcus, or Bacillus was 100 micrograms/mL or less at all pH's tested. Staphylococcus aureus was resistant to this acid at pH 6.8, but became as sensitive as Streptococcus when the pH was lowered. The growth of P. acnes, the most predominant resident bacterium, was enhanced markedly and reached a maximum level at 6.25 mg/mL of propionic acid, 12.5 mg/mL of acetic acid, and 50-100 micrograms/mL of oleic acid. On the basis of these results, we presumed that acetic, propionic, and oleic acids are factors influencing the predominant residence of some species of Propionibacterium and coagulase-negative Staphylococcus on normal human skin.
The intracellular pH of the Gram-positive skin bacterium Propionibacterium acnes was determined using the pH-sensitive fluorescent probe 2',7'-bis-(2-carboxyethyl)-5-(and-6)carboxyfluorescein (BCECF). The probe was introduced into the bacteria using the membrane-permeable acetoxymethyl ester BCECF-AM. The intracellular pH of the bacteria was determined by establishing a relation between the fluorescence ratio 505/450 and pH using the ionophore nigericin. To verify the intracellular pH determined using BCECF, the results were compared with those obtained using 31P-NMR spectroscopy. The effects of different external pH values and glucose addition upon the intracellular pH were examined using BCECF and 31P-NMR. Good correlation was obtained between the two techniques. Propionibacterium acnes maintained a pH gradient, inside alkaline, in the external pH range 5.0-7.4, which inverted when the pH was > 7.5. At external pH > or equal to 8.5, the intracellular pH was close to the external pH. Glucose exposure did not affect the intracellular pH. Rapid, transient intracellular acidification and alkalinization brought about using NaHCO3 and NH4Cl, respectively, could be detected using BCECF. A limitation encountered when using BCECF was BCECF leakage, which could significantly affect the results if not taken into account.
Adhesion to the intestinal mucosa is generally considered an important property of probiotic microorganisms and has been related to many of their health benefits. This study investigated some factors that could affect or be involved in the adherence of Propionibacterium acidipropionici CRL 1198, a dairy strain with suggested probiotic effects and high adherence in vitro and in vivo to intestinal epithelial cells. In vitro adhesion of propionibacteria was decreased by gastric digestion but not affected by bile and pancreatic enzymes. Adherence was also decreased by pretreatment of bacterial cells with protease, sodium metaperiodate, and trichloroacetic acid, revealing that different features of the cell surface, like protein factors, carbohydrates, and teichoic acids, are involved in the process. Adherence to intestinal epithelial cells was enhanced by calcium and was dependent on other divalent cations. Adhesion to intestinal mucus was also demonstrated. The results should explain the metabolic effects in the host previously obtained with this strain and support the potential of Propionibacterium for development of new probiotics.
A cutaneous isolate of Staphylococcus epidermidis, Staphylococcus aureus and Propionibacterium acnes was grown in continuous culture at varying pH-values ranging from 5.0 to 8.5. In terms of the specific growth rate as well as the bacterial density during the plateau phase there were remarkable differences. In particular, Propionibacterium acnes grew much better in the pH 6.0 to 7.0 range than in a more acidic or alkaline milieu. Staphylococcus epidermidis resembled Staphylococcus aureus showing no major difference at pH 5.5 and 7.0. These findings substantiate the hypothesis that minor changes of the pH in the pH 5.5 to pH 6.0 range as to be induced by chemically neutral or alkaline skin cleansers on the human skin surface can increase the number of propionibacteria but not staphylococci remarkably due to the relative alkalinity by itself.
During growth of Propionibacterium acnes on Eagles medium protoporphyrin was accumulated inside the cells and coproporphyrin, both as a free base as metalcontaining, outside the cells. The photochemical processes in the endogenous porphyrins were studied by fluorescence spectroscopy during continuous irradiation of Propionibacterium acnes in suspension. The irradiation caused initially an increase in the content of protoporphyrin in the cells in comparison to that which had been accumulated during growth. Maximum light induced protoporphyrin production was achieved in 5 days old cultures. In old cultures where there was practically no initial protoporphyrin release, the fluorescence intensities from all the porphyrins present in the culture vanished exponentially with the irradiation time. The metal containing form of fluorescent coproporphyrin, with a maximum emission at 580 nm, was photobleached about ten times faster than the free base forms of coproporphyrin and protoporphyrin. Among these three fluorescent substances in the cell culture only the free base forms of the porphyrins have longer lifetimes than the cells themselves irradiated at the same conditions.
The increase of DNA-synthesis rate (according incorporation [8-14C]adenine) in B12-deficient cells Propionibacterium shermanii as a result of different cobalamines adding into the cell suspension including metoxyethyladenile analog of adenozilcobalamin and some components of vitamin B12 molecule has been found. The DNA-synthesis rate in B12-deficient cells is nearly twice lower as compared with one in B12-normal cells. Considerable stimulative effect (80-100%) was provided with coenzyme forms of cobalamin. The data confirm the participation of vitamin B12 in DNA-synthesis in Propionibacterium cells.
A 24-year-old woman had a Propionibacterium acnes infection of a total hip arthroplasty. The clinical course of an infection with this organism has been previously described in detail. The radiologic appearance of a well-circumscribed lytic defect in the femoral shaft is also an unusual if not unique presentation of late infection after total hip arthroplasty. Moreover, simple excision of this infected nidus coupled with antibiotic therapy achieved a complete clinical recovery, in sharp contrast to the more radical procedures generally required for other infections. The predominance of this organism in skin flora, as well as its presence as a contaminant in the operating room environment, implicates Propionibacterium acnes as a potential intraoperative pathogen.
The traditional view that Propionibacterium acnes is nonpathogenic for man, except as an agent associated with acne vulgaris, has been refuted. Propionibacterium acnes has been shown to cause endocarditis, meningitis, and other serious infections. We report a case of P acnes infection causing septic arthritis and contributing to a concurrent soft-tissue infection. This case supports and extends previous observations of the clinical importance of P acnes as a pathogen. A positive culture for P acnes cannot be uncritically dismissed as a bothersome contaminant without considering the clinical circumstances.
Delicate branching filaments, and cocci or rods, were seen by microscopic examination in the pus of the canaliculus lacrimalis in patients with chronic canaliculitis. Propionibacterium propionicus and different bacteria were cultivated and identified in the pus. After i.p. inoculation of mice with the Propionibacterium strains, the morphological changes characteristic of this microorganism were observed in the peritoneum, in the spleen and in the lung, giving an adequate explanation of the direct microscopic findings in the pus.
Propionibacterium are producers of vitamin B-12 and organic acids and are of importance in national economy. Genetics of this organism was studied insufficiently. We constructed the genomic library of Propionibacterium shermanii in cells of Escherichia coli using the plasmid vector pVZ361 and identified recA gene. The vector gives a chance for direct selection of Str-resistant clones containing an insert in BamHI site. The recombinant plasmid carrying the recA gene of P. shermanii was isolated from the genomic library using complementation in E. coli. Strains E. coli C600 and HB101 were transformed by hybrid plasmids, and UV-light-resistant clones were identified. The clones were purified and subjected to treatment with 4-NQO and MMS. Diagrams reflecting survival dependence of the bacteria carrying recombinant plasmids and lacking them on the mutagen concentration and UV-light dose clearly confirmed functioning of P. shermanii recA gene in E. coli cells. The insert with recA gene underwent restriction analysis. The 1.7 kb fragment with recA gene was then transferred to pBI101 plasmid and the resultant recombinant plasmid was used in the SOS test. The mutagens (MMS, 4-NHQ) and UV-light induced the SOS response in E. coli HB101 (recA) carrying the recombinant plasmid.
Propionibacterium acnes belongs to the cutaneous flora of humans and is rarely considered a pathogen in human diseases. It is a frequent contaminant in blood cultures; however, in some patients it has been identified as the causative agent of life-threatening infections. Within the last years we have observed an abrupt increase in severe P. acnes infections which prompted us to study in detail the clinical and microbiological features, risk factors, and outcomes of these cases. In a retrospective review of microbiological records of 905 Propionibacterium isolates from a five-year period (1990-95), 70 were identified from 20 patients with clinical and microbiological evidence of a P. acnes infection. The clinical syndromes included endocarditis (7 patients), post-craniotomy infections (6 patients), arthritis and spondylodiscitis (4 patients), endophthalmitis (2 patients) and pansinusitis (1 patient). The predominant predisposing conditions were previous surgery preceding the infection from 2 weeks to 4 years and implantation of foreign bodies such as prosthetic heart valves, intraocular lenses and ventriculo-peritoneal shunts. Therapy consisted of intravenous antibiotics in all cases and surgical procedures to remove infected tissue in eighteen patients. The outcome was favorable in sixteen patients (80 percent) who had a complete recovery. These data confirm the pathogenic potential of P. acnes in late post-surgical infections, in particular after implantation of a foreign body, and suggest a combined therapeutic approach with intravenous antibiotics and surgical removal of the infected tissue.
Fifty strains of Propionibacterium acnes, five strains with the previous designation Corynebacterium parvum and three strains of Propionibacterium avidum were agglutinated by Bacto-Corynebacterium acnes 554 antiserum (Difco); it was not possible to isolate any strain reacting only with 605 antiserum. Only one strain of C. parvum reacted with both sera. 48 (88 per cent) out of 54 strains (P. acnes and C. parvum) belonged to Voss' group I and 25 (47 per cent) belonged to Pulverer's biotype A. Strains from different diagnostic materials differed only biochemically (species acnes and avidum). The relations between these two species are discussed.
198 strains of Propionibacterium acnes, P. avidum, and P. granulosum were tested for their immunostimulatory potency using splenomegaly as index of stimulation, the activity differed widely from strain to strain. The antitumor and antimetastatic properties of six strains with differing stimulation activities were carefully examined. A close correlation between spleen enlargement and antitumor effects could be observed. The simple spleen enlargement test is recommended for determination of the immunopotency of propionibacteria and for the standardisation of vaccine preparations.
Propionibacterium acnes is a pleomorphic gram-positive anaerobic rod usually isolated as a contaminant from skin. We report three cases of P. acnes infection of central nervous system shunts for hydrocephalus. The organism was seen repeatedly on gram stain in a specimen of shunt fluid in all three cases; initially, it was regarded as a contaminant. In addition, two of the patients had precipitins to extracts of their organism. Serum from normal control subjects had no such precipitins. One of the patients had an immune-complex glomerulonephritis--an entity not previously associated with anaerobic organisms. All three patients recovered after removal of the shunt and treatment with antibiotics. P. acnes is a significant pathogen in patients with central nervous system shunts.
The susceptibility of 98 Propionibacterium acnes, P. granulosum and P. avidum strains isolated from acne cases and appropriate reference strains to decanoic, dodecanoic, octadeca-9,12 dienoic, and octadeca-9,12,15 trienoic acids was investigated using minimal inhibitory concentration estimation by an agar dilution techique. The tested acids showed their relative antibacterial activity in the following order: C18:3 delta 9,12,15 greater than C18:2 delta 9,12 greater than C12:0 greater than C10:0 Differences between minimal inhibitory concentration values for P. acnes, and P. avidum versus P. granulosum strains were demonstrated in the cases of octadeca-9,12 dienoic, and octadeca-9,12,15 trienoic acids.
Attempts were made to produce antisera to purified preparations of Propionibacterium acnes lipase, hyaluronate lyase and acid phosphatase in rabbits. Antiserum to lipase (neutralizing titre I:32) was produced using conventional methods. Lipase (30 micrograms) in Freund's complete adjuvant (FCA) was injected into multiple sites thrice at weekly intervals. Antibody levels were boosted by i.v. injections of 30 micrograms in saline at 2-weekly intervals for 2 months. Such regimes failed to raise antibodies to hyaluronate lyase and acid phosphatase. In order to produce antiserum to hyaluronate lyase, rabbit mononuclear cells were incubated with 45 micrograms of hyaluronate lyase in vitro (I h at 37 degrees C) prior to injection subcutaneously above the rabbit ankle joint. Simultaneous injections of hyaluronate lyase in FCA (45 micrograms) were administered into the footpad and thigh. Three treatments at weekly intervals produced an antiserum with a neutralizing titre of I:256. A similar regime failed to raise antibodies to acid phosphatase. Antibodies to P. acnes lipase and hyaluronate lyase also neutralize the enzymes produced by P. granulosum. The neutralization curves suggest that the enzymes produced by both species are related antigenically but not identical.