ArticlePloS one2017
Propionibacterium acnes biofilm is present in intervertebral discs of patients undergoing microdiscectomy.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 2 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Evidence for infection in intervertebral disc degeneration: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Pooled it
- The bacteria-positive proportion in the disc tissue samples from surgery: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2019Pooled it
- Cytokine Patterns as Predictors of Antibiotic Treatment Effect in Chronic Low Back Pain with Modic Changes: Subgroup Analyses of a Randomized Trial (AIM Study).Journal of pain research · 2023Trial
- Clinical effect modifiers of antibiotic treatment in patients with chronic low back pain and Modic changes - secondary analyses of a randomised, placebo-controlled trial (the AIM study).BMC musculoskeletal disorders · 2020Trial
- IntradiscalJOR spine · 2026Article
- Intradiscal linezolid (PP353) treatment for chronic low back pain associated with Modic change type 1: an international, first-in-human, randomised, sham procedure-controlled, double-blind, phase 1b clinical trial.EClinicalMedicine · 2026Article
- Intervertebral disc puncture predisposes the disc to Cutibacterium acnes infection via hematogenous and contiguous routes: a rat model study.Journal of orthopaedic surgery and research · 2026Article
- Gut mucosal microbiota and local intervertebral disc immunity: candidate circulating-cytokine-independent pathways informed by Mendelian randomization evidence.Frontiers in immunology · 2026Review
- Review
- Intracellular Detection ofJOR spine · 2025Article
- Article
- Frozen Shoulder as a Metabolic and Immune Disorder: Potential Roles of Leptin Resistance, JAK-STAT Dysregulation, and Fibrosis.Journal of clinical medicine · 2025Review
- Gut microbiome dysbiosis implicates the gut-bone axis in Modic changes: a metagenomic case-control study.Frontiers in microbiology · 2025Article
- The identification of low-pathogenic bacteria on removed spinal implants and implications for antimicrobial prophylaxis.Brain & spine · 2025Article
- Molecular Mechanisms of Intervertebral Disc Degeneration Induced byBioMed research international · 2025Review
- Article
- Preclinical development and characterisation of PP353, a formulation of linezolid for intradiscal administration.JOR spine · 2024Article
- Gut microbiome dysbiosis is associated with lumbar degenerative spondylolisthesis in symptomatic patients.JOR spine · 2024Article
- Presentation and management of infection in total disc replacement: A review.North American Spine Society journal · 2024Review
- Induction of cervical disc degeneration and discogenic pain by low concentration Propionibacterium acnes infection: an in vivo animal study.Arthritis research & therapy · 2024Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
35 authors at 20 institutions in 3 countries.
Funding
Abstract
backgroundIn previous studies, Propionibacterium acnes was cultured from intervertebral disc tissue of ~25% of patients undergoing microdiscectomy, suggesting a possible link between chronic bacterial infection and disc degeneration. However, given the prominence of P. acnes as a skin commensal, such analyses often struggled to exclude the alternate possibility that these organisms represent perioperative microbiologic contamination. This investigation seeks to validate P. acnes prevalence in resected disc cultures, while providing microscopic evidence of P. acnes biofilm in the intervertebral discs.
methodsSpecimens from 368 patients undergoing microdiscectomy for disc herniation were divided into several fragments, one being homogenized, subjected to quantitative anaerobic culture, and assessed for bacterial growth, and a second fragment frozen for additional analyses. Colonies were identified by MALDI-TOF mass spectrometry and P. acnes phylotyping was conducted by multiplex PCR. For a sub-set of specimens, bacteria localization within the disc was assessed by microscopy using confocal laser scanning and FISH.
resultsBacteria were cultured from 162 discs (44%), including 119 cases (32.3%) with P. acnes. In 89 cases, P. acnes was cultured exclusively; in 30 cases, it was isolated in combination with other bacteria (primarily coagulase-negative Staphylococcus spp.) Among positive specimens, the median P. acnes bacterial burden was 350 CFU/g (12 - ~20,000 CFU/g). Thirty-eight P. acnes isolates were subjected to molecular sub-typing, identifying 4 of 6 defined phylogroups: IA1, IB, IC, and II. Eight culture-positive specimens were evaluated by fluorescence microscopy and revealed P. acnes in situ. Notably, these bacteria demonstrated a biofilm distribution within the disc matrix. P. acnes bacteria were more prevalent in males than females (39% vs. 23%, p = 0.0013).
conclusionsThis study confirms that P. acnes is prevalent in herniated disc tissue. Moreover, it provides the first visual evidence of P. acnes biofilms within such specimens, consistent with infection rather than microbiologic contamination.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.