Robert Whitfield MD explains why normal skin bacteria like Cutibacterium acnes and Staphylococcus epidermidis matter clinically. A positive culture means nothing without context: where it came from, how much grew, whether there's inflammation, and whether it matches the patient's symptoms and surgical findings.
Why do Cutibacterium acnes and Staph epidermidis keep coming up? Both are familiar members of the normal skin associated with our microbiome on the skin, and both are capable of forming biofilms. The other Corynebacterium can also be part of the skin flora. And so, this is how I got started in this because I had patients keep having normal skin flora on their culture results. And so, the location, the abundance, tissue response, contamination controls, pathology, symptoms, operative findings, and consistency across all of this actually matter.
