Staphylococcus aureus versus Staphylococcus epidermidis in periprosthetic joint infection—Outcome analysis of methicillin-resistant versus methicillin-susceptible strains

Hischebeth, Gunnar; Randau, Thomas M.; Plöeger, Milena M.; Friedrich, M; Kaup, Eva; Jacobs, Cheryl; Molitor, Ernst; Hoerauf, Achim; Gravius, Sascha; Wimmer, Matthias

doi:10.1016/j.diagmicrobio.2018.08.012

Cited by 44 publications

(28 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study has some limitations that need to be taken into account when interpreting the results. Hischebeth et al showed that MRSE infections are more difficult to cure than MRSA infections [21]. However, in our study, we used MSSE instead of MRSE due to safety aspects and to avoid unnecessary use of MRSE.…”

Section: Discussionmentioning

confidence: 98%

“…In literature, various models have been established to determine the antimicrobial activity of antimicrobial coatings most of which use MRSA as contaminant [52]. Recent findings emphasize that in clinical reality its "little brother" methicillin-resistant Staphyloccocus epidermidis (MRSE) is even harder to cure and spreads around the globe undetected [21,61]. In our study design, we therefore tested the antimicrobial activity of the SML coating against MSSE, which is associated with a strong biofilm forming capacity [62].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antimicrobial Silver Multilayer Coating for Prevention of Bacterial Colonization of Orthopedic Implants

Fabritius¹,

Al-Munajjed²,

Freytag³

et al. 2020

Materials

View full text Add to dashboard Cite

Due to increasing rates of periprosthetic joint infections (PJI), new approaches are needed to minimize the infection risk. The first goal of this study was to modify a well-established infection model to test surface-active antimicrobial systems. The second goal was to evaluate the antimicrobial activity of a silver multilayer (SML) coating. In vitro tests with SML items showed a >4 Log reduction in a proliferation assay and a 2.2 Log reduction in an agar immersion test (7 d). In the in vivo model blank and SML coated K-wires were seeded with ~2 × 104 CFU of a methicillin-sensitive Staphylococcus epidermidis (MSSE) and inserted into the intramedullary tibial canal of rabbits. After 7 days, the animals were sacrificed and a clinical, microbiological and histological analysis was performed. Microbiology showed a 1.6 Log pathogen reduction on the surface of SML items (p = 0.022) and in loosely attached tissue (p = 0.012). In the SML group 7 of 12 SML items were completely free of pathogens (cure rate = 58%, p = 0.002), while only 1 of 12 blank items were free of pathogens (cure rate = 8%, p = 0.110). No silver was detected in the blood or urine of the SML treated animals and only scarcely in the liver or adjacent lymph nodes. In summary, an in vivo infection model to test implants with bacterial pre-incubation was established and the antimicrobial activity of the SML coating was successfully proven.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Antimicrobial Silver Multilayer Coating for Prevention of Bacterial Colonization of Orthopedic Implants

Fabritius¹,

Al-Munajjed²,

Freytag³

et al. 2020

Materials

View full text Add to dashboard Cite

show abstract

“…Meanwhile, chronic MRSA-PJIs that underwent two-stage exchange had likewise a high reinfection rate [8, 9, 25]. In a study by Parvizi et al ., an 82% infection control rate was achieved [9].…”

Section: Discussionmentioning

confidence: 99%

“…performed two-stage exchange surgeries and compared the success rates between drug-resistant and drug-susceptible groups. They documented an 80% success rate for MRSA-PJIs as compared to 92.6% for MSSA-PJIs [8]. Kilgus et al .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Improved treatment strategies can result in better outcomes following one-stage exchange surgery for MRSA periprosthetic joint infection

Ohlmeier

Filitarin

Delgado

et al. 2020

Journal of Medical Microbiology

View full text Add to dashboard Cite

Introduction. Periprosthetic joint infections caused by methicillin-resistant Staphylococcus aureus (MRSA-PJIs) are rare, with only a few studies reporting the treatment outcomes and even fewer reporting outcomes with one-stage exchange. Aim. This study aims to analyse the outcomes of one-stage exchange in the management of MRSA-PJIs. Methodology. Patients with MRSA-PJI of the hip and knee, who were treated with a one-stage exchange between 2001 and 2018 were enrolled in this study. The final cohort comprised of 29 patients, which included 23 hips and six knees. The mean follow-up was 5.3 years (1–9 years). Reinfection and complications rates after the one-stage exchange were analysed. Results. Overall infection control could be achieved in 93.1 % (27 out of 29 patients). The overall revision rate was 31.0% (9 patients), with three patients requiring an in-hospital revision (10.3 %). Six patients had to be revised after hospital discharge (20.7 %). Of the two reinfections, one had a growth of MRSA while the other was of methicillin-sensitive Staphyloccocus epidermidis. Conclusion. One-stage exchange surgery using current techniques could improve surgical outcomes with excellent results in the management of MRSA-PJIs.

show abstract

Combined Infection Control and Enhanced Osteogenic Differentiation Capacity on Additive Manufactured Ti‐6Al‐4V are Mediated via Titania Nanotube Delivery of Novel Biofilm Inhibitors

Mutreja

Hooper

et al. 2020

Adv Materials Inter

View full text Add to dashboard Cite

Additive manufacturing (AM) of titanium alloys offers the capacity to fabricate patient-specific implants with defined porous architecture to enhance bone-implant fixation. However, clinical challenges associated with orthopedic implants include inconsistent osseointegration and biofilm-associated peri-implant infection, leading to implant failure. Here, a strategy is developed to reduce infection and promote osteogenesis simultaneously on AM Ti-6Al-4V implants by delivering biofilm inhibitor molecules via titania nanotube surface modification. Electrochemical anodization is performed on polished and as-manufactured Ti-6Al-4V to generate nanotubes, which are utilized for delivery of a novel methylthioadenosine nucleosidase inhibitor (MTANi) that targets MTAN-a key enzyme in bacterial metabolism involved in biofilm formation-thereby offering biofilm inhibition capacity combined with surface nano-topography for promoting osteogenesis. Clinical isolates of staphylococcus cohnii formed firm biofilms on polished and AM Ti-6Al-4V controls whereas modified implants loaded with MTANi inhibit biofilm formation. Anodized AM Ti-6Al-4V nanotube substrates enhance alkaline phosphatase production, bone-specific protein expression (osteocalcin, collagen I) and mineral deposition of human mesenchymal stromal cells (hMSCs), compared to as-manufactured controls. Importantly, no detrimental effects on hMSC proliferation and osteogenic differentiation are observed for MTANi-loaded substrates. Application of novel MTANi and electrochemical anodization offers a promising strategy for titanium alloy implant surface modification.

show abstract

Staphylococcus aureus versus Staphylococcus epidermidis in periprosthetic joint infection—Outcome analysis of methicillin-resistant versus methicillin-susceptible strains

Cited by 44 publications

References 32 publications

Antimicrobial Silver Multilayer Coating for Prevention of Bacterial Colonization of Orthopedic Implants

Antimicrobial Silver Multilayer Coating for Prevention of Bacterial Colonization of Orthopedic Implants

Improved treatment strategies can result in better outcomes following one-stage exchange surgery for MRSA periprosthetic joint infection

Combined Infection Control and Enhanced Osteogenic Differentiation Capacity on Additive Manufactured Ti‐6Al‐4V are Mediated via Titania Nanotube Delivery of Novel Biofilm Inhibitors

Contact Info

Product

Resources

About