Orthopaedic biofilm infections

Zimmerli, Werner; Sendi, Parham

doi:10.1111/apm.12687

Cited by 257 publications

(230 citation statements)

References 96 publications

(153 reference statements)

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“…Similar to PJI, osteomyelitis is very challenging to treat, especially in the chronic setting where biofilms play a role. 50 Yilmaz et al established a biofilm associated osteomyelitis model in rats using methicillin resistant S. aureus (MRSA) and P. aeruginosa. The efficacy of phages, antibiotics, and combination of both therapies to treat the infection were compared.…”

Section: Pre-clinical Applications Of Phage Therapy In Bone Related Imentioning

confidence: 99%

Current review—The rise of bacteriophage as a unique therapeutic platform in treating peri‐prosthetic joint infections

Akanda

Taha

Abdelbary

2017

Journal Orthopaedic Research

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Peri-prosthetic joint infection (PJI) is one of the most serious and dreaded complications after total joint replacement (TJR). Due to an aging population and the constant rise in demand for TJR, the incidence of PJI is also increasing. Successful treatment of PJI is challenging and is associated with high failure rates. One of the main causes for treatment failure is bacterial biofilm formation on implant surfaces and the adherence of biofilm bacteria on tissue and bone next to the implant. Biofilms are protective shields to bacterial cells and possess many unique properties that leads to antibiotic resistance. New therapeutic platforms are currently being explored to breakdown biofilm matrix in order to enhance the efficacy of antibiotics. Bacteriophages (phages) is one of these unique therapeutic platforms that can degrade biofilms as well as target the killing of bacterial cells. Preclinical studies of biofilm-mediated infections have demonstrated the ability of phage to eradicate biofilms and clear infections by working synergistically with antibiotics. There is strong preclinical evidence that phage can reduce the concentration of antibiotics required to treat an infection. These findings support a promising role for phages as a future clinical adjunct to antibiotics. In addition, phage therapy can be personalized to target a specific bacterial strain. Clinical studies using phage therapy are limited in Western literature; but phase I studies have established good safety profile with no adverse outcomes reported. In order to translate phage therapy to treat PJI in clinics, further preclinical testing is still required to study optimal delivery methods as well as the interaction between phage and the immune system in vivo. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1051-1060, 2018.

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Section: Pre-clinical Applications Of Phage Therapy In Bone Related Imentioning

confidence: 99%

Current review—The rise of bacteriophage as a unique therapeutic platform in treating peri‐prosthetic joint infections

Akanda

Taha

Abdelbary

2017

Journal Orthopaedic Research

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“…Pseudomonas infection formed film-like strings on many bone specimens, similar to biofilms that form on orthopedic hardware which are exceedingly difficult to clear. 41 After peracetic acid treatment, biofilms were no longer visible and bacterial titers were undetectable. Positive spike of specimens showed that bacteria were still recoverable from decellularized specimens.…”

Section: Bacterial Pathogen Clearancementioning

confidence: 99%

A porcine xenograft‐derived bone scaffold is a biocompatible bone graft substitute: An assessment of cytocompatibility and the alpha‐Gal epitope

Bracey

Seyler

Jinnah

et al. 2019

Xenotransplantation

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Background:Xenografts are an attractive alternative to traditional bone grafts because of the large supply from donors with predictable morphology and biology as well as minimal risk of human disease transmission. Clinical series involving xenograft bone transplantation, most commonly from bovine sources, have reported poor results with frequent graft rejection and failure to integrate with host tissue. Failures have been attributed to residual alpha-Gal epitope in the xenograft which humans produce natural antibody against. To the authors' knowledge, there is currently no xenograft-derived bone graft substitute that has been adopted by orthopedic surgeons for routine clinical use.Methods: In the current study, a bone scaffold intended to serve as a bone graft substitute was derived from porcine cancellous bone using a tissue decellularization and chemical oxidation protocol. In vitro cytocompatibility, pathogen clearance, and alpha-Gal quantification tests were used to assess the safety of the bone scaffold intended for human use.

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“…Infectious processes in biofilm are divided into two types, namely device-and non-device-associated infections [5]. Device-associated infections are caused by microbial colonization of medical devices such as urinary catheters, bone joints, heart valves, dental implants, prostheses, contact lenses, and endotracheal tubes [5][6][7][8][9][10]. The occurrence of nosocomial infections through biomaterials or implants is approximately 60-70%; of those, 720,000 cases of central line-associated bloodstream infections occur annually in the USA via dialysis and intensive care units with an associated 12% mortality and a $45,000 increase in treatment cost per episode [11].…”

Section: Introductionmentioning

confidence: 99%

Anti-Biofilm Effects of Synthetic Antimicrobial Peptides Against Drug-Resistant Pseudomonas aeruginosa and Staphylococcus aureus Planktonic Cells and Biofilm

et al. 2019

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Biofilm-associated infections are difficult to manage or treat as biofilms or biofilm-embedded bacteria are difficult to eradicate. Antimicrobial peptides have gained increasing attention as a possible alternative to conventional drugs to combat drug-resistant microorganisms because they inhibit the growth of planktonic bacteria by disrupting the cytoplasmic membrane. The current study investigated the effects of synthetic peptides (PS1-2, PS1-5, and PS1-6) and conventional antibiotics on the growth, biofilm formation, and biofilm reduction of drug-resistant Pseudomonas aeruginosa and Staphylococcus aureus. The effects of PS1-2, PS1-5, and PS1-6 were also tested in vivo using a mouse model. All peptides inhibited planktonic cell growth and biofilm formation in a dose-dependent manner. They also reduced preformed biofilm masses by removing the carbohydrates, extracellular DNA, and lipids that comprised extracellular polymeric substances (EPSs) but did not affect proteins. In vivo, PS1-2 showed the greatest efficacy against preformed biofilms with no cytotoxicity. Our findings indicate that the PS1-2 peptide has potential as a next-generation therapeutic drug to overcome multidrug resistance and to regulate inflammatory response in biofilm-associated infections.

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Orthopaedic biofilm infections

Cited by 257 publications

References 96 publications

Current review—The rise of bacteriophage as a unique therapeutic platform in treating peri‐prosthetic joint infections

Current review—The rise of bacteriophage as a unique therapeutic platform in treating peri‐prosthetic joint infections

A porcine xenograft‐derived bone scaffold is a biocompatible bone graft substitute: An assessment of cytocompatibility and the alpha‐Gal epitope

Anti-Biofilm Effects of Synthetic Antimicrobial Peptides Against Drug-Resistant Pseudomonas aeruginosa and Staphylococcus aureus Planktonic Cells and Biofilm

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