Author:
Chen Sihui,Jiang Yi,Wang Wei,Chen Junjie,Zhu Jinyu
Abstract
Abstract
Background
Iodophors are known to be a treatment for biofilm-related periprosthetic joint infection. However, the efficacy and mechanism of eradicating biofilms from different artificial joint materials after iodophor treatment are unknown. This study was conducted to understand the effect and mechanism of iodophors with respect to the adhesion and virulence of Staphylococcus aureus biofilms attached to artificial joint materials.
Methods
Biofilms of Staphylococcus aureus strains were grown on titanium alloy, cobalt chromium molybdenum and polyethylene coupons, which are commonly used materials for artificial joints, for 24 h. Afterward, all coupons were divided into experimental and control groups: (1) exposed to a 0.5 ± 0.05% iodophor for 5 min and (2) exposed to phosphate-buffered saline for 5 min. To gauge the level of biofilm, colony forming units (CFU), live/dead staining confocal microscopy and crystal violet staining were used. Meanwhile, the expression of icaACDR and clfA, which are related to virulence and adhesion, was examined in both the experimental and control groups.
Results
A roughly three-log decrease in CFU/cm2 was seen in the viable plate count compared to the control group. Confocal imaging and crystal violet staining verified the CFU data. Moreover, the expression of icaACDR was reduced on three different orthopaedic implant materials, and the expression of clfA was also inhibited on titanium alloy coupons exposed to the iodophor.
Conclusions
Our results indicated that exposure to an iodophor for 5 min could significantly eliminate biofilms. When Staphylococcus aureus that had adhered to these three materials, which were used for artificial joints, was treated with an iodophor for 5 min, the expression of icaACDR was significantly reduced. This provides strong evidence for clinically clearing periprosthetic joint infections without removing the artificial joints.
Funder
the Key Laboratory Project of Jiaxing; China
the Key Departments of Jiaxing; China
Basic Public Welfare Research Program of Zhejiang Province
internal funding of First Hospital of Jiaxing; China
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Surgery
Reference46 articles.
1. Patel R. Periprosthetic joint infection. N Engl J Med. 2023;388(3):251–62.
2. Tande AJ, Patel R. Prosthetic joint infection. Clin Microbiol Rev. 2014;27(2):302–45.
3. Migliorini F, Weber CD, Bell A, et al. Bacterial pathogens and in-hospital mortality in revision surgery for periprosthetic joint infection of the hip and knee: analysis of 346 patients. Eur J Med Res. 2023;28(1):177.
4. Zheng S, Bawazir M, Dhall A, et al. Implication of surface properties, bacterial motility, and hydrodynamic conditions on bacterial surface sensing and their initial adhesion. Front Bioeng Biotechnol. 2021;9: 643722.
5. Pietrocola G, Campoccia D, Motta C, et al. Colonization and infection of indwelling medical devices by Staphylococcus aureus with an emphasis on orthopedic implants. Int J Mol Sci. 2022;23(11):5958.