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Introduction <p>Although <i>Cutibacterium acnes</i> is considered a typical pathogen of postoperative central nervous system (CNS) infections, data on its role as a pathogen, remain limited. This study aimed to address this knowledge gap.</p> Methods <p>A case–case–control study of adults with monomicrobial <i>Cutibacterium acnes</i> infections (CaIs) following nonspine neurosurgical procedures (2016–2024) (Cases I). These were individually matched (1:1:1) by age, year, and procedure type to individuals who did not develop infection (controls) and to individuals with aerobic bacterial infections (abIs; cases II). Multivariable conditional logistic regression models were implemented to assess clinical correlates for infection by either bacterial group, clinical presentation, and outcomes differences.</p> Results <p><i>Cutibacterium acnes</i> isolation predominantly reflected contamination (131/213, 62%), and ultimately 32 (15%) CaIs cases were included. Smoking (adjusted odds ratio [aOR] 3.25, 95% confidence interval [CI] 1.06–9.97) was the only independent risk factor identified for CaIs. In contrast, nonelective procedure was identified as an independent risk factor for abIs (aOR 6.0, 95% CI 1.34–26.81, <i>p</i> = 0.019). CaIs commonly involved empyema (84% [27/32] versus 53% [17/32] with abIs, <i>p</i> = 0.014). Individuals with CaIs tended to follow a relatively indolent clinical course, were less likely to present with fever (aOR 0.15, 95% CI 0.04–0.68), and had favorable outcomes. When compared with CaIs, patients with abIs were less likely to achieve clinical cure at 90 days (aOR 0.02, 95% CI 0.001–0.41).</p> Conclusions <p>Although no modifiable risk factors were identified, CaIs frequently caused empyema, were less likely to present with fever, and were associated with a favorable prognosis.</p>

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Post-cranial Neurosurgery Cutibacterium acnes Infections: Clinical Correlates, Presentation, and Outcomes—A Matched Case–Case–Control Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月14日

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  • Neta Shirin,
  • Ofek Arviv,
  • Karina Zinman,
  • Bar Mizrahi,
  • Yovel Peretz,
  • Sarit Moshayev Revale,
  • Idan Levitan,
  • Elena Mishuk,
  • Lior Ungar,
  • Asaf Biber,
  • Sharon Amit,
  • Tal Zilberman-Daniels,
  • Zvi R. Cohen,
  • Dafna Yahav,
  • Ili Margalit

摘要

Introduction

Although Cutibacterium acnes is considered a typical pathogen of postoperative central nervous system (CNS) infections, data on its role as a pathogen, remain limited. This study aimed to address this knowledge gap.

Methods

A case–case–control study of adults with monomicrobial Cutibacterium acnes infections (CaIs) following nonspine neurosurgical procedures (2016–2024) (Cases I). These were individually matched (1:1:1) by age, year, and procedure type to individuals who did not develop infection (controls) and to individuals with aerobic bacterial infections (abIs; cases II). Multivariable conditional logistic regression models were implemented to assess clinical correlates for infection by either bacterial group, clinical presentation, and outcomes differences.

Results

Cutibacterium acnes isolation predominantly reflected contamination (131/213, 62%), and ultimately 32 (15%) CaIs cases were included. Smoking (adjusted odds ratio [aOR] 3.25, 95% confidence interval [CI] 1.06–9.97) was the only independent risk factor identified for CaIs. In contrast, nonelective procedure was identified as an independent risk factor for abIs (aOR 6.0, 95% CI 1.34–26.81, p = 0.019). CaIs commonly involved empyema (84% [27/32] versus 53% [17/32] with abIs, p = 0.014). Individuals with CaIs tended to follow a relatively indolent clinical course, were less likely to present with fever (aOR 0.15, 95% CI 0.04–0.68), and had favorable outcomes. When compared with CaIs, patients with abIs were less likely to achieve clinical cure at 90 days (aOR 0.02, 95% CI 0.001–0.41).

Conclusions

Although no modifiable risk factors were identified, CaIs frequently caused empyema, were less likely to present with fever, and were associated with a favorable prognosis.