Sphingosine is able to prevent and eliminate Staphylococcus epidermidis biofilm formation on different orthopedic implant materials in vitro

Abstract

Periprosthetic infection (PPI) is a devastating complication in joint replacement surgery. On the background of an aging population, the number of joint replacements and associated complications is expected to increase. The capability for biofilm formation and the increasing resistance of different microbes to antibiotics have complicated the treatment of PPI, requiring the need for the development of alternative treatment options. The bactericidal effect of the naturally occurring amino alcohol sphingosine has already been reported. In our study, we demonstrate the antimicrobial efficacy of sphingosine on three different strains of biofilm producing Staphylococcus epidermidis, representing one of the most frequent microbes involved in PPI. In an in vitro analysis, sphingosine's capability for prevention and treatment of biofilm-contamination on different common orthopedic implant surfaces was tested. Coating titanium implant samples with sphingosine not only prevented implant contamination but also revealed a significant reduction of biofilm formation on the implant surfaces by 99.942%. When testing the antimicrobial efficacy of sphingosine on sessile biofilm-grown Staphylococcus epidermidis, sphingosine solution was capable to eliminate 99.999% of the bacteria on the different implant surfaces, i.e., titanium, steel, and polymethylmethacrylate. This study provides evidence on the antimicrobial efficacy of sphingosine for both planktonic and sessile biofilm-grown Staphylococcus epidermidis on contaminated orthopedic implants. Sphingosine may provide an effective and cheap treatment option for prevention and reduction of infections in joint replacement surgery. Key messages • Here we established a novel technology for prevention of implant colonization by sphingosine-coating of orthopedic implant materials. • Sphingosine-coating of orthopedic implants prevented bacterial colonization and significantly reduced biofilm formation on implant surfaces by 99.942%. • Moreover, sphingosine solution was capable to eliminate 99.999% of sessile biofilm-grown Staphylococcus epidermidis on different orthopedic implant surfaces.

The Anti-Infectious Role of Sphingosine in Microbial Diseases

“…This work was the first to report that sphingosine administered by inhalation acted against S. aureus in airways and could prevent airway infection. Based on these findings, the use of sphingosine on implanted medical devices was proposed to prevent staphylococcal infections [ 29 , 35 ]. About 25% of mechanically ventilated patients are affected by ventilator-associated pneumonia, which has an estimated mortality of 13% [ 52 ].…”

Antimicrobial Activity of Host-Derived Lipids

“…Beck and colleagues [90] applied a sphingosine coating on titanium, commonly used for orthopedic implants. This treatment was 99.999% successful in preventing S. epidermidis biofilm growth even when immersed in a bacterial culture.…”

Metabolism, ATP production and biofilm generation by Staphylococcus epidermidis in either respiratory or fermentative conditions

“…There is an active search for materials to coat implant surfaces which may prevent biofilm formation (Rabin et al 2015). Among these, zirconium nitride has shown promise in orthopaedic implants (Pilz et al 2019), while sphingosine coating is being used with success on implant titanium-surfaces (Beck et al 2019). Inside the body, this bacterium has to face attack from the immune system, high [O 2 ] (Fang et al 2016) and antibiotics (Leid 2009), most likely triggering a stress response.…”