General Assembly, Prevention, Hospital Environment: Proceedings of International Consensus on Orthopedic Infections

Barnes, C. Lowry; Cooper, A.; Luque, Jose; Manghwani, Jitesh; Matar, Wadih Y.; Panda, Inayat; Rajgopal, Ashok; Vaidya, Shrinand V; Wakde, Om

doi:10.1016/j.arth.2018.09.068

Cited by 4 publications

(2 citation statements)

References 65 publications

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“…[24][25][26] Significantly, the incidence of surgical site infections increases linearly with time in the OR, [27][28][29][30] and, while a direct link is difficult to establish, there is strong agreement that OR contamination is linked to device infection. [31][32][33][34] To address the implant-infection problem, there has been a rapidly growing surge in the development of a wide variety of antimicrobial biomaterials over the past two decades. [35][36][37][38][39][40][41] This has necessitated the concurrent development and implementation of a range of in vitro methods designed to characterize the antimicrobial properties of these materials.…”

Section: Introductionmentioning

confidence: 99%

“…Increased infection control has steadily reduced that rate, and more recent reports measure rates ranging from 10 3 –10 4 CFU/m 2 −h 24–26 . Significantly, the incidence of surgical site infections increases linearly with time in the OR, 27–30 and, while a direct link is difficult to establish, there is strong agreement that OR contamination is linked to device infection 31–34 …”

Section: Introductionmentioning

confidence: 99%

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An in vitro model of microbial contamination in the operating room

et al. 2022

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Infection associated with tissue‐contacting biomedical devices is a compelling clinical problem initiated by the microbial colonization of the device surface. Among the possible sources of contaminating bacteria is the operating room (OR) itself, where viable bacteria in the atmosphere can sediment onto a device surface intraoperatively. We have developed an aerosolizing system that can reproducibly spray small quantities of aerosolized bacteria onto a surface to mimic OR contamination. This paper describes the design of the system and characterizes key aspects associated with its operation. The area density of sprayed bacteria is on the order of 102/cm2. Using titanium (Ti) alloy coupons as test substrates contaminated by staphylococci, we quantify the fraction of bacteria that are well adhered to the substrate, those that can be removed by sonication, and those that are not recovered after spraying. Despite the relatively low levels of surface contamination, we furthermore show that such a model is able to demonstrate a statistically significant reduction in colonization of Ti coupons modified by antimicrobial quaternary ammonium compounds relative to unmodified controls.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An in vitro model of microbial contamination in the operating room

et al. 2022

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Peptoid‐Loaded Microgels Self‐Defensively Inhibit Staphylococcal Colonization of Titanium in a Model of Operating‐Room Contamination

Zhao

Wang

Xiao

et al. 2022

Adv Materials Inter

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Bacterial contamination of an exposed implantable medical device by the atmosphere of an operating room (OR) is increasingly implicated as a cause of device‐associated infection. Here, OR contamination is modeled in vitro using an aerosolizing system to spray small quantities of staphylococci onto titanium rods. Contaminated rods always manifest culturable bacteria. Self‐assembly is used to create a self‐defensive Ti surface that substantially enhances the rod's resistance to such contamination. Poly(acrylic acid) microgels are electrostatically deposited onto small Ti rods and subsequently loaded by complexation with a cationic antimicrobial peptoid (TM1). The microgels are visualized in situ by optical microscopy, and changes in microgel diameter indicate the loading state. These measurements show that TM1 can be quickly loaded from low‐ionic‐strength buffer and subsequently remained sequestered within the microgels for up to 4 weeks when soaked in phosphate buffered saline. TM1‐loaded microgel‐modified Ti surfaces are contaminated with aerosolized staphylococci, and subsequent assays indicate few or no culturable bacteria. In the absence of nutrients to enable metabolism, this finding suggests that bacteria trigger local TM1 release by contact transfer. The modified surfaces exhibit good in vitro cytocompatibility as manifested by the adhesion, spreading, and metabolic activity of human fetal osteoblasts.

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