Linear-Chain Nanostructured Carbon with a Silver Film Plated on Metal Components Has a Promising Effect for the Treatment of Periprosthetic Joint Infection

Background: Due to the aging of the world population, the number of joint diseases, along with the number of arthroplasties, has increased, simultaneously increasing the amount of complications, including periprosthetic joint infection (PPI). In this study, to combat a PPI, we investigated the antimicrobial properties of the new composite cover for titanium implants, silver-doped carbyne-like carbon (S-CLC) film. Methods: The first assay investigated the antimicrobial activity against Pseudomonas aeruginosa and releasing of silver ions from S-CLC films into growth media covered with S-CLC with a thickness of 1, 2, and 4 mm. The second assay determined the direct antibacterial properties of the S-CLC film’s surface against Staphylococcus aureus, Enterococcus faecalis, or P. aeruginosa. The third assay studied the formation of microbial biofilms of S. aureus or P. aeruginosa on the S-CLC coating. Silver-doped carbyne-like carbon (S-CLC)-covered or titanium plates alone were used as controls. Results: S-CLC films, compared to controls, prevented P. aeruginosa growth on 1 mm thickness agar; had direct antimicrobial properties against S. aureus, E. faecalis, and P. aeruginosa; and could prevent P. aeruginosa biofilm formation. Conclusions: S-CLC films on the Ti surface could successfully fight the most common infectious agent in PPI, and prevented biofilm formation.

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A Case of Periprosthetic Joint Infection Because of Rothia Mucilaginosa

Military Medicine ◽

10.1093/milmed/usab203 ◽

2021 ◽

Author(s):

Janse T Schermerhorn ◽

Donald F Colantonio ◽

Derek T Larson ◽

Robert J McGill

Keyword(s):

Knee Arthroplasty ◽

Periprosthetic Joint Infection ◽

Joint Infection ◽

Diagnostic Delay ◽

Infectious Agent ◽

Two Stage ◽

Treatment Regimens ◽

History Of ◽

Rothia Mucilaginosa ◽

One Year

ABSTRACT Periprosthetic joint infection (PJI) is a rare but devastating complication of total joint arthroplasty. Identifying the offending infectious agent is essential to appropriate treatment, and uncommon pathogens often lead to a diagnostic delay. This case describes the first known instance of a total knee arthroplasty (TKA) with Rothia mucilaginosa, a typical respiratory tract organism. This report aims to provide insight into the treatment of this atypical PJI, as there are only six previously published cases of Rothia species PJI septic arthritis. The patient is a 64-year-old diabetic male who underwent a right TKA and left TKA ∼6 months later. Approximately 3 weeks status post-left TKA, he showed evidence of left PJI. One year after treatment and recovery from his left PJI, he presented with several months of right knee pain and fatigue. Subsequent labs and imaging revealed right PJI. No recent history of dental disease or work was observed. He then underwent two-stage revision right knee arthroplasty and microbial cultures yielded Rothia mucilaginosa. After initial empiric treatment, antibiotic therapy was narrowed to 6 weeks of vancomycin. Following negative aspiration cultures the patient underwent reimplantation of right TKA components. One year following treatment, the patient was fully recovered with no evidence of infection. This case emphasizes the possibility of microbial persistence despite various antibiotic treatment regimens for the patient’s contralateral knee arthroplasty and PJI. Additionally, this case demonstrates the importance of two-stage revision in patients with PJI, and the viability of treating Rothia species PJIs with vancomycin.

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A novel antimicrobial coating to prevent periprosthetic joint infection

Bone and Joint Research ◽

10.1302/2046-3758.912.bjr-2020-0157.r1 ◽

2020 ◽

Vol 9 (12) ◽

pp. 848-856

Author(s):

Rita Ramalhete ◽

Robyn Brown ◽

Gordon Blunn ◽

John Skinner ◽

Melanie Coathup ◽

...

Keyword(s):

Stem Cells ◽

Periprosthetic Joint Infection ◽

Biofilm Formation ◽

Autologous Blood ◽

Joint Infection ◽

In Vivo Studies ◽

Dependent Manner ◽

Bacterial Reduction ◽

Log Reduction ◽

Antimicrobial Coating

Aims Periprosthetic joint infection (PJI) is a debilitating condition with a substantial socioeconomic burden. A novel autologous blood glue (ABG) has been developed, which can be prepared during surgery and sprayed onto prostheses at the time of implantation. The ABG can potentially provide an antimicrobial coating which will be effective in preventing PJI, not only by providing a physical barrier but also by eluting a well-known antibiotic. Hence, this study aimed to assess the antimicrobial effectiveness of ABG when impregnated with gentamicin and stem cells. Methods Gentamicin elution from the ABG matrix was analyzed and quantified in a time-dependent manner. The combined efficiency of gentamicin and ABG as an anti-biofilm coating was investigated on titanium disks. Results ABG-gentamicin was bactericidal from 10 μg/ml and could release bactericidal concentrations over seven days, preventing biofilm formation. A concentration of 75 μg/ml of gentamicin in ABG showed the highest bactericidal effect up to day 7. On titanium disks, a significant bacterial reduction on ABG-gentamicin coated disks was observed when compared to both uncoated (mean 2-log reduction) and ABG-coated (mean 3-log reduction) disks, at days 3 and 7. ABG alone exhibited no antimicrobial or anti-biofilm properties. However, a concentration of 75 μg/ml gentamicin in ABG sustains release over seven days and significantly reduced biofilm formation. Its use as an implant coating in patients with a high risk of infection may prevent bacterial adhesion perioperatively and in the early postoperative period. Conclusion ABG’s use as a carrier for stem cells was effective, as it supported cell growth. It has the potential to co-deliver compatible cells, drugs, and growth factors. However, ABG-gentamicin’s potential needs to be further justified using in vivo studies. Cite this article: Bone Joint Res 2020;9(12):848–856.

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Quantification of Peri-Implant Bacterial Load and in Vivo Biofilm Formation in an Innovative, Clinically Representative Mouse Model of Periprosthetic Joint Infection

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.16.00815 ◽

2017 ◽

Vol 99 (6) ◽

pp. e25 ◽

Cited By ~ 21

Author(s):

Alberto V. Carli ◽

Samrath Bhimani ◽

Xu Yang ◽

Matthew B. Shirley ◽

Karen L. de Mesy Bentley ◽

...

Keyword(s):

Mouse Model ◽

Periprosthetic Joint Infection ◽

Biofilm Formation ◽

Joint Infection ◽

Bacterial Load

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Effects of Ciprofloxacin on the Dynamics of Biofilm Formation by Staphylococcus Epidermidis Strains Isolated from Implant-Associated Infection

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2020-13-3-241-247 ◽

2020 ◽

Vol 13 (3) ◽

pp. 241-247

Author(s):

Irina V. Babushkina ◽

Irina A. Mamonova ◽

Vladimir Yu. Ulyanov ◽

Sergey P. Shpinyak ◽

Aleksandr S. Bondarenko

Keyword(s):

Periprosthetic Joint Infection ◽

Staphylococcus Epidermidis ◽

Biofilm Formation ◽

Gentian Violet ◽

Joint Infection ◽

Multidrug Resistant ◽

Diagnostic Methods ◽

Microbial Biofilms ◽

Large Joint

Introduction. The formation of a microbial biofilm in implant-associated infection after arthroplasty of large joints reduces the informative value of traditional microbiological diagnostic methods and limits the range of effective antimicrobial drugs. When prescribing etiotropic therapy for periprosthetic joint infection, it is necessary to take into account not only the antibacterial effect of the drug, but also its effect on biofilm formation. Ciprofloxacin therapy may be a risk factor for the development of biofilm periprosthetic infection caused by multidrug-resistant staphylococcal strains.The aim of research was to study the effect of sub-inhibiting and therapeutic doses of ciprofloxacin on biofilm formation by Staphylococcus epidermidis strains isolated from implant-associated infection.Materials and methods. The authors studied the effect of various concentrations of ciprofloxacin on 15 strains of St. epidermidis isolated from 83 patients with deep periprosthetic joint infection after primary knee arthroplasty, treated at NIITON SSMU in 2018-2019. The effect of the calculated concentrations of ciprofloxacin on the planktonic culture, forming and preformed biofilms was investigated. Biofilm simulation was performed according to the method described by G.D. Christensen under in vitro conditions with determination of the optical density of alcohol eluates of gentian violet in polystyrene microplates.Results. It was demonstrated that ciprofloxacin in a dose 0.01 g/ml inhibits the growth of planktonic forms by 50% and statistically significantly (p = 0.001) stimulates formation of microbial biofilms as compared to the control without antibiotic addition. Concentration of ciprofloxacin equal 0.03 g/ml inhibits the growth of planktonic forms by 90%, statistically significantly (p = 0.001) stimulates formation of biofilms and activates further increase in the mass of pre-formed microbial biofilms. An increase in the concentration of ciprofloxacin to 0.05 g/ml completely inhibits the growth of planktonic forms and statistically significantly stimulates further growth of preformed biofilms.The use of ciprofloxacin at concentrations equal 1-3 g/ml statistically significantly (p = 0.001) inhibits the formation of microbial biofilms, but does not affect the preformed biofilm.Conclusions. Thus, there has been found a dose-dependent effect of ciprofloxacin towards clinical strains of St. epidermidis: subinhibitory and therapeutic concentrations of the drug have a stimulating effect on the formation and further increase in the mass of the preformed microbial biofilms. This fact must be taken into account when prescribing etiotropic therapy for implant-associated complications following large joint replacements.

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In Vitro Activity of Vancapticin MCC5145 against Methicillin-Resistant Staphylococcus aureus from Periprosthetic Joint Infection

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02443-20 ◽

2021 ◽

Author(s):

Hye-Kyung Cho ◽

Melissa J. Karau ◽

Kerryl E. Greenwood-Quaintance ◽

Karl A. Hansford ◽

Matthew A. Cooper ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Periprosthetic Joint Infection ◽

Biofilm Formation ◽

Methicillin Resistant Staphylococcus Aureus ◽

Joint Infection ◽

Vitro Activity ◽

In Vitro Activity ◽

Methicillin Resistant

MRSA periprosthetic 1 joint infection (PJI) can be challenging to treat due to biofilm formation, alongside sometimes limited vancomycin activity (1-3).…

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Microbial Decontamination and Antibacterial Activity of Nanostructured Titanium Dental Implants: A Narrative Review

Nanomaterials ◽

10.3390/nano11092336 ◽

2021 ◽

Vol 11 (9) ◽

pp. 2336

Author(s):

Sepanta Hosseinpour ◽

Ashwin Nanda ◽

Laurence J. Walsh ◽

Chun Xu

Keyword(s):

Dental Implants ◽

Biofilm Formation ◽

Periodontal Diseases ◽

Bacterial Load ◽

Antibacterial Properties ◽

Titanium Implants ◽

Treatment Modalities ◽

Advantages And Disadvantages ◽

Number Of Patients ◽

Titanium Dental Implants

Peri-implantitis is the major cause of the failure of dental implants. Since dental implants have become one of the main therapies for teeth loss, the number of patients with peri-implant diseases has been rising. Like the periodontal diseases that affect the supporting tissues of the teeth, peri-implant diseases are also associated with the formation of dental plaque biofilm, and resulting inflammation and destruction of the gingival tissues and bone. Treatments for peri-implantitis are focused on reducing the bacterial load in the pocket around the implant, and in decontaminating surfaces once bacteria have been detached. Recently, nanoengineered titanium dental implants have been introduced to improve osteointegration and provide an osteoconductive surface; however, the increased surface roughness raises issues of biofilm formation and more challenging decontamination of the implant surface. This paper reviews treatment modalities that are carried out to eliminate bacterial biofilms and slow their regrowth in terms of their advantages and disadvantages when used on titanium dental implant surfaces with nanoscale features. Such decontamination methods include physical debridement, chemo-mechanical treatments, laser ablation and photodynamic therapy, and electrochemical processes. There is a consensus that the efficient removal of the biofilm supplemented by chemical debridement and full access to the pocket is essential for treating peri-implantitis in clinical settings. Moreover, there is the potential to create ideal nano-modified titanium implants which exert antimicrobial actions and inhibit biofilm formation. Methods to achieve this include structural and surface changes via chemical and physical processes that alter the surface morphology and confer antibacterial properties. These have shown promise in preclinical investigations.

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