Biofilm and orthopaedic practice: the world of microbes in a world of implants

Galanakos, Spyridon P.; Papadakis, Stamatios A.; Kateros, Konstantinos; Papakostas, Ioannis; Macheras, George A.

doi:10.1016/j.mporth.2009.02.002

Cited by 8 publications

(8 citation statements)

References 23 publications

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“…These results demonstrated the efficacy of the biomimetic coatings combined with tobramycin, to prevent local post-surgical infections in orthopedic surgery 94 . The most important fact is that bacteria normally grow as biofilms 95 . The bacteria in biofilms can be differentiated from free-floating planktonic forms by an extracellular polymeric substance, slower growth rate and the up- or down-regulation of certain genes.…”

Section: Bacterial Adhesionmentioning

confidence: 75%

Infection of orthopedic implants with emphasis on bacterial adhesion process and techniques used in studying bacterial-material interactions

2012

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Staphylococcus comprises up to two-thirds of all pathogens in orthopedic implant infections and they are the principal causative agents of two major types of infection affecting bone: septic arthritis and osteomyelitis, which involve the inflammatory destruction of joint and bone. Bacterial adhesion is the first and most important step in implant infection. It is a complex process influenced by environmental factors, bacterial properties, material surface properties and by the presence of serum or tissue proteins. Properties of the substrate, such as chemical composition of the material, surface charge, hydrophobicity, surface roughness and the presence of specific proteins at the surface, are all thought to be important in the initial cell attachment process. The biofilm mode of growth of infecting bacteria on an implant surface protects the organisms from the host immune system and antibiotic therapy. The research for novel therapeutic strategies is incited by the emergence of antibiotic-resistant bacteria. This work will provide an overview of the mechanisms and factors involved in bacterial adhesion, the techniques that are currently being used studying bacterial-material interactions as well as provide insight into future directions in the field.

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Section: Bacterial Adhesionmentioning

confidence: 75%

Infection of orthopedic implants with emphasis on bacterial adhesion process and techniques used in studying bacterial-material interactions

2012

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“…The typical causative organisms possess characteristics that render greater resistance to the host’s immune response and antibiotic therapy. Bacteria may persist in a biofilm-based colony or be intracellular, concealed within osteoblasts [ 1 , 2 ]. While chronic haematogenous osteomyelitis is not associated with skeletal instability, it frequently involves a large segment of bone.…”

Section: Introductionmentioning

confidence: 99%

The outcome of treatment of chronic osteomyelitis according to an integrated approach

Marais

Ferreira

Aldous

et al. 2016

Strategies in Trauma and Limb Reconstruction

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Previous classification systems of chronic osteomyelitis have failed to provide objective and pragmatic guidelines for selection of the appropriate treatment strategy. In this study, we assessed the short-term treatment outcome in adult patients with long-bone chronic osteomyelitis prospectively where a modified host classification system was integrated with treatment strategy selection through a novel management algorithm. Twenty-six of the 28 enrolled patients were available for follow-up at a minimum of 12 months. The median patient age of was 36.5 years (range 18–72 years). Fourteen patients (54 %) were managed palliatively, and 11 patients (42 %) were managed through the implementation of a curative treatment strategy. One patient required alternative treatment in the form of an amputation. The overall success rate was 96.2 % (95 % CI 80.4–99.9 %) at a minimum of 12-months follow-up. Remission was achieved in all [11/11] patients treated curatively (one-sided 95 % CI 73.5–100.0 %). Palliative treatment was successful in 92.9 % [13/14] of cases (95 % CI 66.1–99.9 %). In patients with lower limb involvement, there was a statistically significant improvement of 28.3 (95 % CI 21.0–35.7; SD 17.0) in the AAOS Lower Limb Outcomes Instrument score (p value < 0.001). The integrated approach proposed in this study appears a useful guideline to the management of chronic osteomyelitis of long bones in adult patients in the developing world. Further investigation is required to validate the approach, and additional development of the algorithm may be required in order to render it useful in other clinical environments.

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“…Therefore, it is important to prevent formation of biofilm on orthopaedic implanted devices to avoid one of the catastrophic complications in orthopaedic surgery ie. infection 6,12,20 . The use of materials and coatings that release antimicrobials effect can be applied to prevent colonization and consequent biofilm formation.…”

Section: Discussionmentioning

confidence: 99%

“…The use of materials and coatings that release antimicrobials effect can be applied to prevent colonization and consequent biofilm formation. It is considered as one of the practical strategies due to release of antimicrobials effect in lethal concentration for any local planktonic cell before they form biofilm 6 .…”

Section: Discussionmentioning

confidence: 99%

“…It is a thin layer where the colonisation of bacteria will be 10-1000 fold more resistant to antibiotics and external environment compared with the bacteria in planktonic form 5 . Furthermore, ineffective attempts of polymorphonuclear neutrophils penetration into the biofilm may result in periprosthetic osteolysis specifically for orthopaedic implants due to the release of cytotoxic and proteolytic substances 6 . Therefore, because of such ability of Staphylococcus epidermidis to attach, colonise and form biofilm on the implanted biomaterials surface, it is important to develop and implement therapeutic strategies and effective infection control measures, particularly for the orthopaedic implanted devices 2 .…”

Section: National Nosocomial Infection Surveillancementioning

confidence: 99%

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Cinnamon Oil and Chitosan Coating on Orthopaedic Implant Surface for Prevention of Staphylococcus Epidermidis Biofilm Formation

Magetsari¹,

Dewo²,

Saputro³

et al. 2014

MOJ

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S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistant compared to the planktonic form. This study was carried out to determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 times using a mixture of cinnamon oil and chitosan 3% and 2% respectively with serial concentration of cinnamon from 0.125% to 2%. The coated implants were then put into tubes that contained bacterial suspension and incubated. Subsequently, the implants were washed with PBS solution followed by MTT soulution and isopropanol acid solution. that related to biofilm formation. The results were expressed in numbers which represents the absorbance level at ELISA readings on 575 nm (A575) wavelength.The stainless steel implant coated with chitosan and cinnamon oil 2% and 1% has lower absorbance level compared with the absorbance level of S.Epidermidis biofilm only. This study showed that mixture of cinnamon oil and chitosan coated on the surface of stainless steel orthopaedic implant has an effect against S.Epidermidis biofilm formation with the minimum cinnamon oil concentration of 1%.

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Biofilm and orthopaedic practice: the world of microbes in a world of implants

Cited by 8 publications

References 23 publications

Infection of orthopedic implants with emphasis on bacterial adhesion process and techniques used in studying bacterial-material interactions

Infection of orthopedic implants with emphasis on bacterial adhesion process and techniques used in studying bacterial-material interactions

The outcome of treatment of chronic osteomyelitis according to an integrated approach

Cinnamon Oil and Chitosan Coating on Orthopaedic Implant Surface for Prevention of Staphylococcus Epidermidis Biofilm Formation

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