scholarly journals Implant materials and prosthetic joint infection: the battle with the biofilm

2019 ◽  
Vol 4 (11) ◽  
pp. 633-639 ◽  
Author(s):  
Donald J. Davidson ◽  
David Spratt ◽  
Alexander D. Liddle
Keyword(s):  
Prosthetic Joint Infection ◽  
Clinical Medicine ◽  
Clinical Success ◽  
Joint Infection ◽  
Treatment Strategies ◽  
Surface Coatings ◽  
Implant Surface ◽  
Prosthetic Joint ◽  
Significant Burden ◽  
New Treatment

Prosthetic joint infection (PJI) is associated with poor clinical outcomes and is expensive to treat. Although uncommon overall (affecting between 0.5% and 2.2% of cases), PJI is one of the most commonly encountered complications of joint replacement and its incidence is increasing, putting a significant burden on healthcare systems. Once established, PJI is extremely difficult to eradicate as bacteria exist in biofilms which protect them from antibiotics and the host immune response. Improved understanding of the microbial pathology in PJI has generated potential new treatment strategies for prevention and eradication of biofilm associated infection including modification of implant surfaces to prevent adhesion of bacteria. Much research is currently ongoing looking at different implant surface coatings and modifications, and although most of this work has not translated into clinical medicine there has been some early clinical success.Cite this article: EFORT Open Rev 2019;4:633-639. DOI: 10.1302/2058-5241.4.180095

scholarly journals SAAP-148 Eradicates MRSA Persisters Within Mature Biofilm Models Simulating Prosthetic Joint Infection

2021 ◽  
Vol 12 ◽  
Author(s):  
Henk Scheper ◽  
Julia M. Wubbolts ◽  
Joanne A. M. Verhagen ◽  
Adriëtte W. de Visser ◽  
Robert J. P. van der Wal ◽  
...  
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Treatment Strategies ◽  
Antibacterial Activities ◽  
Current Treatment ◽  
Log Reduction ◽  
Prosthetic Joint ◽  
Novel Treatment Strategies ◽  
Titanium Aluminium

Prosthetic joint infection (PJI) is a severe complication of arthroplasty. Due to biofilm and persister formation current treatment strategies often fail. Therefore, innovative anti-biofilm and anti-persister agents are urgently needed. Antimicrobial peptides with their broad antibacterial activities may be such candidates. An in vitro model simulating PJI comprising of rifampicin/ciprofloxacin-exposed, mature methicillin-resistant Staphylococcus aureus (MRSA) biofilms on polystyrene plates, titanium/aluminium/niobium disks, and prosthetic joint liners were developed. Bacteria obtained from and residing within these biofilms were exposed to SAAP-148, acyldepsipeptide-4, LL-37, and pexiganan. Microcalorimetry was used to monitor the heat flow by the bacteria in these models. Daily exposure of mature biofilms to rifampicin/ciprofloxacin for 3 days resulted in a 4-log reduction of MRSA. Prolonged antibiotic exposure did not further reduce bacterial counts. Microcalorimetry confirmed the low metabolic activity of these persisters. SAAP-148 and pexiganan, but not LL-37, eliminated the persisters while ADEP4 reduced the number of persisters. SAAP-148 further eradicated persisters within antibiotics-exposed, mature biofilms on the various surfaces. To conclude, antibiotic-exposed, mature MRSA biofilms on various surfaces have been developed as in vitro models for PJI. SAAP-148 is highly effective against persisters obtained from the biofilms as well as within these models. Antibiotics-exposed, mature biofilms on relevant surfaces can be instrumental in the search for novel treatment strategies to combat biofilm-associated infections.

scholarly journals Salvage Debridement, Antibiotics and Implant Retention (“DAIR”) With Local Injection of a Selected Cocktail of Bacteriophages: Is It an Option for an Elderly Patient With Relapsing Staphylococcus aureus Prosthetic-Joint Infection?

2018 ◽  
Vol 5 (11) ◽  
Author(s):  
Tristan Ferry ◽  
Gilles Leboucher ◽  
Cindy Fevre ◽  
Yannick Herry ◽  
Anne Conrad ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Prosthetic Joint Infection ◽  
Clinical Success ◽  
Joint Infection ◽  
Salvage Treatment ◽  
Local Injection ◽  
Scientific Evaluation ◽  
Potential Clinical Benefit ◽  
Prosthetic Joint ◽  
Implant Retention

Abstract Local injection of a bacteriophages mix during debridement, antibiotics and implant retention (“DAIR”) was performed to treat a relapsing Staphylococcus aureus chronic prosthetic joint infection (PJI). This salvage treatment was safe and associated with a clinical success. Scientific evaluation of the potential clinical benefit of bacteriophages as antibiofilm treatment in PJI is now feasible and required.

What is the optimal duration of intravenous antibiotics following single-stage revision total hip arthroplasty for prosthetic joint infection? A systematic review

2020 ◽  
pp. 112070002092285
Author(s):  
Nemandra A Sandiford ◽  
Anna McHale ◽  
Mustafa Citak ◽  
Daniel Kendoff
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Contemporary Literature ◽  
Treatment Strategies ◽  
Antibiotic Use ◽  
Single Stage ◽  
Fundamental Aspect ◽  
Prosthetic Joint ◽  
Time Period ◽  
Optimal Duration

Prosthetic joint infection (PJI) is 1 of the most challenging potential complications following total joint arthroplasty. Several surgical treatment strategies have been proposed for management of this diagnosis. The single-stage approach has been gaining popularity in contemporary literature. 1 fundamental aspect in the management of hip PJI is the administration of antibiotics, usually intravenously immediately after surgery, followed by a period of oral antibiotics. The optimal duration of the period of antibiotic therapy is undecided. The aim of this paper is to examine the trend in intravenous antibiotic use over the last 18 years and examine the influence this has had on the results of single-stage revision over that time period.

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