防腐剂
生物膜
表皮葡萄球菌
铜绿假单胞菌
医学
微生物学
关节置换术
洗必泰
关节感染
假体周围
细菌
金黄色葡萄球菌
生物
外科
关节置换术
牙科
病理
遗传学
作者
Jeffrey O’Donnell,Mark Wu,Niall H. Cochrane,Elshaday Belay,Matthew Myntti,Garth A. James,Sean P. Ryan,Thorsten M. Seyler
出处
期刊:The bone & joint journal
[British Editorial Society of Bone and Joint Surgery]
日期:2021-05-01
卷期号:103-B (5): 908-915
被引量:14
标识
DOI:10.1302/0301-620x.103b5.bjj-2020-1245.r2
摘要
Aims Periprosthetic joint infections (PJIs) are among the most devastating complications after joint arthroplasty. There is limited evidence on the efficacy of different antiseptic solutions on reducing biofilm burden. The purpose of the present study was to test the efficacy of different antiseptic solutions against clinically relevant microorganisms in biofilm. Methods We conducted an in vitro study examining the efficacy of several antiseptic solutions against clinically relevant microorganisms. We tested antiseptic irrigants against nascent (four-hour) and mature (three-day) single-species biofilm created in vitro using a drip-flow reactor model. Results With regard to irrigant efficacy against biofilms, Povidone-iodine treatment resulted in greater reductions in nascent MRSA biofilms (logarithmic reduction (LR) = 3.12; p < 0.001) compared to other solutions. Bactisure treatment had the greatest reduction of mature Pseudomonas aeruginosa biofilms (LR = 1.94; p = 0.032) and a larger reduction than Vashe or Irrisept for mature Staphylococcus epidermidis biofilms (LR = 2.12; p = 0.025). Pooled data for all biofilms tested resulted in Bactisure and Povidone-iodine with significantly greater reductions compared to Vashe, Prontosan, and Irrisept solutions (p < 0.001). Conclusion Treatment failure in PJI is often due to failure to clear the biofilm; antiseptics are often used as an adjunct to biofilm clearance. We tested irrigants against clinically relevant microorganisms in biofilm in vitro and showed significant differences in efficacy among the different solutions. Further clinical outcome data is necessary to determine whether these solutions can impact PJI outcome in vivo. Cite this article: Bone Joint J 2021;103-B(5):908–915.
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