Scenery of Staphylococcus Implant Infections in Orthopedics

Abstract

Infection is still the major complication of orthopedic implants and projections based on the actual trend indicate that total hip and knee arthroplasties and their consequent infection burden are destined to greatly increase. Staphylococcus aureus and Staphylococcus epidermidis are the leading etiologic agents of orthopedic implant infection. Here we report on epidemiology of implant-related Staphylococcus infections in orthopedics, also referring to our experience, and focus on the crucial role of bacterial adhesins and on their ability to direct the pathogenesis process. Bacteria initiate implant infection by adhering to biomaterials. In the early steps of infection, adhesins mediate the specific interaction between microbial cells and the extracellular matrix proteins filming biomaterial surface. Then adhesin-mediated anchorage allows bacteria to cling to the biomaterial surface and to produce a biofilm that favors their ability to resist antibiotics. With the aim to prevent implant-related infections, anti-infective and infection-resistant biomaterials are being developed. The research for novel therapeutic strategies is incited by the emergence of antibiotic-resistant bacteria. Vaccines against the adhesins or antisense molecules against virulence genes can open a future in combating implant infections.

PVD-grown antibacterial Ag-TiN films on piezoelectric PVDF substrates for sensor applications

“…Although there are some biomaterials presenting suitable mechanical properties and low cytotoxicity, they are often prone to microbial colonization [1,2]. This colonization is frequently associated to Staphylococcus epidermidis, being one of the most common bacteria found in orthopaedics prostheses [3,4]. In addition, infections caused by this microorganism are often associated to implant failure [5].…”

Biofilm formation of Brazilian meticillin-resistant Staphylococcus aureus strains: prevalence of biofilm determinants and clonal profiles

“…It is responsible for several diseases ranging from superficial to invasive infections such as pneumonia and sepsis. These infections are even more severe if a strain with high biofilm formation ability colonizes an invasive medical device (Gordon & Lowy, 2008;Montanaro et al, 2011). The first stage of biofilm formation is cell attachment onto a surface followed by intercellular adhesion, production of an extracellular matrix and then maturation of the biofilm (Otto, 2013).…”

Cementless modular intramedullary nail without bone-on-bone fusion as a salvage procedure in chronically infected total knee prosthesis: long-term results

“…In the orthopaedic field, the issue posed by bacterial infection is considerable, especially because multidrug-resistant microorganisms are among the most frequently reported agents associated with orthopaedic implant infection [3]. Whereas infection after primary joint replacement in normal hosts is relatively rare, occurring in <2 % of patients, septic complications may be much more frequent in immunocompromised hosts or after revision surgery [4].…”