Biofilms in Periprosthetic Orthopedic Infections

Abstract

As the number of total joint arthroplasty and internal fixation procedures continues to rise, the threat of infection following surgery has significant clinical implications. These infections may have highly morbid consequences to patients, who often endure additional surgeries and lengthy exposures to systemic antibiotics, neither of which are guaranteed to resolve the infection. Of particular concern is the threat of bacterial biofilm development, since biofilm-mediated infections are difficult to diagnose and effective treatments are lacking. Developing therapeutic strategies have targeted mechanisms of biofilm formation and the means by which these bacteria communicate with each other to take on specialized roles such as persister cells within the biofilm. In addition, prevention of infection through novel coatings for prostheses and the local delivery of high concentrations of antibiotics by absorbable carriers has shown promise in laboratory and animal studies. Biofilm development, especially in an arthoplasty environment, and future diagnostic and treatment options are discussed.

Adding functionality with additive manufacturing: Fabrication of titanium-based antibiotic eluting implants

“…Future work, which will involve the design of clinically specific implants, will require a longer term release study to be conducted; the time frame of this study will be matched to the desired antibiotic delivery for the chosen clinical application. Typically when an infected implant is removed antibiotics are administered intravenously for 2-8 weeks [41]. Therefore it may be necessary to extend the period in which the antibiotic is released from the implant reservoir.…”

Effects of bone cement loaded with teicoplanin, N-acetylcysteine or their combination on Staphylococcus aureus biofilm formation: an in vitro study

“…Furthermore, S. aureus strains produce stronger biofilm than P. aeroginosa. [1] We found that the NAC and teicoplanin show similar effects on S. aureus, with a significant decrease in the number of colonies formed (p<0.05). However, the combination of NAC with teicoplanin was more effective than NAC alone or teicoplanin alone.…”

“…Infections around the implant are among the most problematic issues of prosthetic medical care, and the treatment of a PJI that has a biofilm on the implant surface is almost impossible without removing the implant [1] In particular, biofilm produced by staphylococci are extremely difficult to eradicate.…”

Therapeutic cyclic lipopeptides mining from microbes: latest strides and hurdles

“…Biofilm formation in the arthroplasty milieu leads to high patient morbidity (McConoughey et al 2014). Despite, technical innovations, the rising cases of MRSA is a serious concern (Bassetti et al 2014).…”