Direct Demonstration of Viable Staphylococcus aureus Biofilms in an Infected Total Joint Arthroplasty

Stoodley, Paul; Nistico, Laura; Johnson, Sharon L.; Lasko, Leslie-Anne; Baratz, Mark E.; Gahlot, Vikram; Ehrlich, Garth D.; Kathju, Sandeep

doi:10.2106/jbjs.g.00838

Cited by 160 publications

(134 citation statements)

References 21 publications

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“…We believe that including both prostheses and internal fixation devices in our study makes sense because similar pathogens have been described in the two settings (41)(42)(43) and biofilm formation is common to all types of foreign-body infections (44)(45)(46). We found that slow-growing microorganisms such as coagulase negative-staphylococci and P. acnes were equally represented in the two groups.…”

Section: Discussionmentioning

confidence: 58%

Optimal Culture Incubation Time in Orthopedic Device-Associated Infections: a Retrospective Analysis of Prolonged 14-Day Incubation

et al. 2014

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Accurate diagnosis of orthopedic device-associated infections can be challenging. Culture of tissue biopsy specimens is often considered the gold standard; however, there is currently no consensus on the ideal incubation time for specimens. The aim of our study was to assess the yield of a 14-day incubation protocol for tissue biopsy specimens from revision surgery (joint replacements and internal fixation devices) in a general orthopedic and trauma surgery setting. Medical records were reviewed retrospectively in order to identify cases of infection according to predefined diagnostic criteria. From August 2009 to March 2012, 499 tissue biopsy specimens were sampled from 117 cases. In 70 cases (59.8%), at least one sample showed microbiological growth. Among them, 58 cases (82.9%) were considered infections and 12 cases (17.1%) were classified as contaminations. The median time to positivity in the cases of infection was 1 day (range, 1 to 10 days), compared to 6 days (range, 1 to 11 days) in the cases of contamination (P < 0.001). Fifty-six (96.6%) of the infection cases were diagnosed within 7 days of incubation. In conclusion, the results of our study show that the incubation of tissue biopsy specimens beyond 7 days is not productive in a general orthopedic and trauma surgery setting. Prolonged 14-day incubation might be of interest in particular situations, however, in which the prevalence of slow-growing microorganisms and anaerobes is higher.

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Section: Discussionmentioning

confidence: 58%

Optimal Culture Incubation Time in Orthopedic Device-Associated Infections: a Retrospective Analysis of Prolonged 14-Day Incubation

et al. 2014

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“…Moreover, FISH and CLSM better demonstrated that pathogen-specific bacteria were present in aggregated 3D structures in tissue samples compared to conventional thin- section hematoxylin-and-eosin staining of the same tissue (data not shown). We have previously used FISH to evaluate multiple clinical tissues for bacterial biofilms in clinical infections where the etiology of infection is unknown (40,51,61), with similar qualitative results.…”

Section: Discussionmentioning

confidence: 94%

Adenoid Reservoir for Pathogenic Biofilm Bacteria

et al. 2011

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Biofilms of pathogenic bacteria are present on the middle ear mucosa of children with chronic otitis media (COM) and may contribute to the persistence of pathogens and the recalcitrance of COM to antibiotic treatment. Controlled studies indicate that adenoidectomy is effective in the treatment of COM, suggesting that the adenoids may act as a reservoir for COM pathogens. To investigate the bacterial community in the adenoid, samples were obtained from 35 children undergoing adenoidectomy for chronic OM or obstructive sleep apnea. We used a novel, culture-independent molecular diagnostic methodology, followed by confocal microscopy, to investigate the in situ distribution and organization of pathogens in the adenoids to determine whether pathogenic bacteria exhibited criteria characteristic of biofilms. The Ibis T5000 Universal Biosensor System was used to interrogate the extent of the microbial diversity within adenoid biopsy specimens. Using a suite of 16 broad-range bacterial primers, we demonstrated that adenoids from both diagnostic groups were colonized with polymicrobial biofilms. Haemophilus influenzae was present in more adenoids from the COM group (P ‫؍‬ 0.005), but there was no significant difference between the two patient groups for Streptococcus pneumoniae or Staphylococcus aureus. Fluorescence in situ hybridization, lectin binding, and the use of antibodies specific for host epithelial cells demonstrated that pathogens were aggregated, surrounded by a carbohydrate matrix, and localized on and within the epithelial cell surface, which is consistent with criteria for bacterial biofilms.

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“…P. aeruginosa is the best characterised bacteria to undergo the genetic adaptations from motile planktonic bacteria to a noncytotoxic, nonmotile, mucoid phenotype caused by overproduction of a surface polysaccharide known as alginate. Biofilm formation also occurs with Haemophilus influenzae and S. aureus, common pathogens in the PCD population [104][105][106]. Bacteria embedded within biofilms can be 1,000-fold more resistant to antibiotic treatments [107].…”

Section: The Value Of Augmentation Of Nitric Oxide Levels In Pcdmentioning

confidence: 99%

Nitric oxide in primary ciliary dyskinesia

et al. 2012

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Nitric oxide is continually synthesised in the respiratory epithelium and is upregulated in response to infection or inflammation. Primary ciliary dyskinesia (PCD) is characterised by recurrent sinopulmonary infections due to impaired mucociliary clearance. Despite chronic infections, nasal nitric oxide in such patients is markedly reduced and is used as a screening test for this condition. These low levels were first described .15 yrs ago but the underlying mechanisms have yet to be fully elucidated. We review epithelial nitric oxide synthesis, release and measurement in the upper airways with particular reference to PCD. The key hypotheses that have been proposed to explain the low nitric oxide levels in this condition are explored and the potential benefits of augmenting airway nitric oxide levels are considered. Further work in these patients clarifying both whether the respiratory epithelium is able to biosynthesise normal levels of nitric oxide and the role played by abnormalities in the anatomy of the paranasal sinuses is essential. While nitric oxide augmentation is unlikely to be beneficial in common PCD phenotypes, it has potential in the treatment of secondary dyskinesias and may also improve treatment of bacterial infections, particularly where biofilms are implicated.

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Direct Demonstration of Viable Staphylococcus aureus Biofilms in an Infected Total Joint Arthroplasty

Cited by 160 publications

References 21 publications

Optimal Culture Incubation Time in Orthopedic Device-Associated Infections: a Retrospective Analysis of Prolonged 14-Day Incubation

Optimal Culture Incubation Time in Orthopedic Device-Associated Infections: a Retrospective Analysis of Prolonged 14-Day Incubation

Adenoid Reservoir for Pathogenic Biofilm Bacteria

Nitric oxide in primary ciliary dyskinesia

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