N‐acetylcysteine eradicates Pseudomonas aeruginosa biofilms in bone cement

Abstract

Biofilm is an example of bacterial group behavior. We investigated the effect of N-acetylcysteine (NAC) alone and in combination with ciprofloxacin on Pseudomonas aeruginosa biofilm formation. Four groups (each contains six molds) of standardized bone cement molds were infected. NAC, ciprofloxacin each alone, and NAC/ciprofloxacin combination were evaluated in point of inhibiting and eradicating biofilm capacity using microbiological and electron microscopical evaluation techniques. Microbial counts and electron microscopical observations showed that the effect of NAC and ciprofloxacin combination on biofilm formation in bone cement is valuable. NAC enhances the beneficial effect of ciprofloxacin when used in combination with it in bone cement. SCANNING 38:766-770, 2016. © 2016 Wiley Periodicals, Inc.

N‐acetylcysteine use as an adjuvant to bone cement to fight periprosthetic joint infections: A preliminary in vitro efficacy and biocompatibility study

“…Therefore, the results are specific to these bacterial strains. However, multiple studies have shown a broad antibacterial effect of NAC, 7–15 and so we expect similar results against other bacteria. Nonetheless, this needs to be verified with future larger studies.…”

“…NAC is widely used in many fields of medicine, which supports its safety profile and availability. Although our study is the first to report evidence supporting its use in bone cement, prior studies have already identified the broad antimicrobial and antibiofilm efficacy of NAC against a multitude of organisms 10–15 . The current study identified the antimicrobial performance from the elution of NAC from NAC–PMMA cement against S. aureus and E. coli .…”

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

“…This is the second study to show the effects of NAC-loaded samples on biofilm formation. However, in the aforementioned study carried out by Onger et al, [23] the antibiofilm effects of NAC were shown on gram-negative bacteria (P. aeroginosa), which are rarely associated with PJIs. By contrast, for the current study, we chose to use gram-positive bacteria (S. aureus); these are the most common infecting agents in PJIs.…”

“…[22] Leite et al [5] have also reported that NAC alone (40 mg/L), or in combination with rifampicin (10 mg/L), reduces the formation of S. epidermidis biofilms. Only one study performed by Onger et al [23] and using in vitro techniques has demonstrated the synergistic effect achieved when bone cement is loaded with both NAC and ciprofloxacin. This is the second study to show the effects of NAC-loaded samples on biofilm formation.…”

In vitro activity of linezolid, daptomycin and n-acetylcysteine agents on staphylococcus aureus biofilms in the ventriculoperitoneal shunt model

“…The eight selected areas were investigated at 10,000× magnification. A histological scoring system was employed according to our previous work (21).…”