High Hydrostatic Pressure for Disinfection of Bone Grafts and Biomaterials: An Experimental Study

Abstract

Abstract:Background: Autoclaving, heat, irradiation or chemical detergents are used to disinfect autografts, allografts and biomaterials for tissue reconstruction. These methods are often associated with deterioration of mechanical, physical, and biological properties of the bone grafts and synthetic implants. High hydrostatic pressure has been proposed as a novel method preserving biomechanical and biological properties of bone, tendon and cartilage. This is the first study to assess the inactivation of clinically relevant bacteria on biomaterials and human bone by high hydrostatic pressure.Methods: Bacterial suspensions of Staphylococcus aureus, Pseudomonas aeruginosa and Enterococcus faecium, implants covered with infected blood, human bone infected in vitro, and biopsies of patients with chronic osteomyelitis were subjected to different protocols of high hydrostatic pressure up to 600 MPa. Bacterial survival after high hydrostatic pressure treatment was determined and compared with bacterial growth in untreated controls.Results: S. aureus and P. aeruginosa in suspension were completely inactivated by high hydrostatic pressure (> 5log levels), whereas E. faecium showed barotolerance up to 600 MPa. Blood and adherence to metal implants did not significantly alter inactivation of bacteria, and complete disinfection was achieved with barotolerant bacteria (S. aureus and P. aeruginosa). However, osteoarthritic bone demonstrated a non-homogeneous baroprotective effect, with single bone samples resistant to treatment resulting in unaltered bacterial growth, and complete disinfection of artificially infected bone specimens was achieved in 66% for S. aureus, 60% for P. aeruginosa and 0% for E. faecium. Human bone samples of patients with chronic osteomyelitis could be completely disinfected in 2 of 37 cases. Conclusion:High hydrostatic pressure offers new perspectives for disinfection of sensitive biomaterials and bone grafts, and contamination by blood did not significantly affect bacterial inactivation rates. However, a significant baroprotective effect was demonstrated in bone. Effectiveness is currently limited to colonization and / or infection with barosensitive micro-organisms.

Pressure to kill or pressure to boost: a review on the various effects and applications of hydrostatic pressure in bacterial biotechnology

“…High-pressure treatment constitutes a valid alternative to gamma ray irradiation, heat treatment, and chemical inactivation that tend to deteriorate the biomechanical properties of the material. As a matter of fact, high pressure was shown not to alter the biomechanical and immunohistochemical properties of the material while being able to inactivate diverse viruses, bacteria, and fungi (Brouillet et al 2009;Diehl et al 2005;Diehl et al 2006;Gollwitzer et al 2009;Naaletal.2008). Nevertheless, Gollitzer et al showed that bacteria embedded in bones were less prone to high pressure inactivation than bacteria in suspension.…”

The development of high hydrostatic pressure processes as an alternative to other pathogen reduction methods

“…2010) with different objectives: (i) the production of microbiologically safe pharmaceutical preparations (Rigaldie et al. 2003; Van Doorne 2008), (ii) the disinfection of medical devices, biomaterials or natural components (Gollwitzer et al. 2009), (iii) the stabilization of proteins intermediates, in particular the ones found in the aggregation and amyloidogenosis phenomena involved in several neurodegenerative diseases (Torrent et al.…”

“…Standard decontamination methods (autoclaving, heat, irradiation, chemical detergents) for biomaterials lead to some deterioration of their physical (in particular mechanical) and biological (such as their ability to be invaded by new cells) properties. Some research works were conducted on the use of HHP processes as an alternative to prepare safe biomaterials, consisting either of tumour afflicted bone segments, contaminated biomaterial surfaces or infected bone fragments (Gollwitzer et al. 2009).…”

“…Over the last 10 years, increasing interest for high-pressure processes in Biology has emerged (Silva et al 2004;Aertsen et al 2009;Rivalain et al 2010) with different objectives: (i) the production of microbiologically safe pharmaceutical preparations Van Doorne 2008), (ii) the disinfection of medical devices, biomaterials or natural components (Gollwitzer et al 2009), (iii) the stabilization of proteins intermediates, in particular the ones found in the aggregation and amyloidogenosis phenomena involved in several neurodegenerative diseases (Torrent et al 2006), (iv) the dissociation of protein complexes (Crisman and Randolph 2009), (v) the development of vaccines (Shearer and Kniel 2009), (vi) the extraction of cell components and the decellularization of tissues to obtain biocompatible scaffolds (Gross et al 2008).…”

“…Standard decontamination methods (autoclaving, heat, irradiation, chemical detergents) for biomaterials lead to some deterioration of their physical (in particular mechanical) and biological (such as their ability to be invaded by new cells) properties. Some research works were conducted on the use of HHP processes as an alternative to prepare safe biomaterials, consisting either of tumour afflicted bone segments, contaminated biomaterial surfaces or infected bone fragments (Gollwitzer et al 2009). These experiments underlined the potentialities of HHP treatments to inactivate either tumour cells or pathogens while maintaining the key properties of the materials which can therefore be re-implanted into the patients (Diehl et al 2004;Schauwecker et al 2006).…”