Antibacterial Properties of Synovial Fluid in the Knee

Gruber, Brian F.; Miller, Bruce S.; Onnen, Jeremy; Welling, Rod; Wojtys, Edward M.

doi:10.1055/s-0030-1262969

Cited by 5 publications

(9 citation statements)

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“…To analyze growth of S. aureus in SF, we compared growth patterns of the CA-MRSA strain USA300 in SF with those in serum and TSB. The number of CFUs indeed decreased in SF (Figure 1A), as noted in a study reporting antimicrobial activity of SF [10]. However, with qPCR analysis, considerable growth was observed in SF, comparable to that in serum (Figure 1B), indicating that SF does not have antimicrobial activity.…”

Section: Effect Of Sf On S Aureussupporting

confidence: 73%

“…It has been speculated that biofilm formation plays a key role [7], a notion that is predominantly based on the isolation of biofilmlike agglomerations from cases of joint infection [8]. Furthermore, the synovial fluid (SF) present in joint cavities has been attributed a function in inhibiting killing of S. aureus by neutrophils [9], while in a somewhat contradicting manner it has also been described as antimicrobial [10]. Finally, microbiological evaluations of joint infections are often complicated by the frequency of falsenegative cultures [11].…”

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confidence: 99%

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Effect of Biofilms on Recalcitrance of Staphylococcal Joint Infection to Antibiotic Treatment

Dastgheyb

Parvızı

Shapiro

et al. 2014

Journal of Infectious Diseases

147

153

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The pathogenesis of joint infections is not well understood. In particular, we do not know why these infections respond poorly to antibiotic treatment. Here we show that methicillin-resistant Staphylococcus aureus, a major cause of joint infections, forms exceptionally strong biofilmlike aggregates in human synovial fluid (SF), to an extent significantly exceeding biofilm formation observed in growth medium or serum. Screening a transposon bank identified bacterial fibronectin- and fibrinogen-binding proteins as important for the formation of macroscopic clumps in SF, suggesting an important role of fibrin-containing clots in the formation of bacterial aggregates during joint infection. Pretreatment of SF with plasmin led to a strongly reduced formation of aggregates and increased susceptibility to antibiotics. These results give important insight into the pathogenesis of staphylococcal joint infection and the mechanisms underlying resistance to treatment. Furthermore, they point toward a potential novel approach for treating joint infections.

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Section: Effect Of Sf On S Aureussupporting

confidence: 73%

mentioning

confidence: 99%

Effect of Biofilms on Recalcitrance of Staphylococcal Joint Infection to Antibiotic Treatment

Dastgheyb

Parvızı

Shapiro

et al. 2014

Journal of Infectious Diseases

147

153

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“…1992; Schneider et al. 1992) and it is recognised that culture of synovial fluid is difficult because of a number of potential factors, such as the sequestration of the bacterium into the synovial membrane (McIlwraith 1983) and the bactericidal qualities of the synovial fluid (DeGara 1943; Gruber et al. 2008).…”

Section: Discussionmentioning

confidence: 99%

Bacterial culture of septic synovial structures of horses: Does a positive bacterial culture influence prognosis?

Taylor¹,

Mair

Smith

et al. 2010

Equine Veterinary Journal

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Fourteen (20.9%) of 67 horses with a positive bacterial culture from synovial fluid were subjected to euthanasia because of persistent synovial sepsis compared to 2 (1.44%) of 139 with negative bacterial cultures (P<0.001). Overall survival and successful long-term return to function in horses with a positive bacterial culture was 50% (24/48 horses) compared to 70.5% (74/105) in culture negative horses (P=0.01). In horses that survived to be discharged, successful long-term return to function was not significantly different between culture positive and culture negative groups. Growth of Staphylococcus aureus from synovial fluid did not affect short-term survival to discharge from the hospital compared to other positive bacterial culture; however, successful long-term return to function was only 30.4% (4/13) in horses from which S. aureus was cultured compared to 73.9% (17/23) of horses in which other bacteria were cultured (P=0.015). CONCLUSIONS AND POTENTIAL CLINICAL RELEVANCE: Horses with a positive bacterial culture from a septic synovitis have a poorer prognosis for survival to discharge from hospital and overall long-term return to function than horses that yielded no bacterial growth. When S. aureus was cultured, the long-term prognosis was poorer.

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“…19,24 Synovial fluid itself may have bactericidal properties. 25,26 Attempts have been made to improve techniques of culture by using different broths and solid culture media, yet still many cultures have false negative results. 27 Modern recovery techniques such as 16S rDNA PCR (universal detection of bacterial presence based on conserved ribosomal DNA sequences) might enhance recovery, but are not yet capable of detecting patterns of resistance and will not be within reach of every microbiology laboratory.…”

Section: Contrast Mediummentioning

confidence: 99%

In vitro study of the antimicrobial effects of radiological contrast agents used in arthrography

Bruins

Zwiers

Verheyen

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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Aspiration arthrography using an iodinated contrast medium is a useful tool for the investigation of septic or aseptic loosening of arthroplasties and of septic arthritis. Previously, the contrast media have been thought to cause false negative results in cultures when present in aspirated samples of synovial fluid, probably because free iodine is bactericidal, but reports have been inconclusive. We examined the influence of the older, high osmolar contrast agents and the low osmolar media used currently on the growth of ten different micro-organisms capable of causing deep infection around a prosthesis. Five media were tested, using a disc diffusion technique and a time-killing curve method in which high and low inocula of micro-organisms were incubated in undiluted media. The only bactericidal effects were found with low inocula of Escherichia coli and Pseudomonas aeruginosa in ioxithalamate, one of the older ionic media. The low and iso-osmolar iodinated contrast media used currently do not impede culture. Future study must assess other causes of false negative cultures of synovial fluid and new developments in enhancing microbial recovery from aspirated samples.

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Antibacterial Properties of Synovial Fluid in the Knee

Cited by 5 publications

References 0 publications

Effect of Biofilms on Recalcitrance of Staphylococcal Joint Infection to Antibiotic Treatment

Effect of Biofilms on Recalcitrance of Staphylococcal Joint Infection to Antibiotic Treatment

Bacterial culture of septic synovial structures of horses: Does a positive bacterial culture influence prognosis?

In vitro study of the antimicrobial effects of radiological contrast agents used in arthrography

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