Wanner S, Gstöttner M, Meirer R, Hausdorfer J, Fille M, Stöckl B
Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Tyrol, Austria.
J Bone Joint Surg Br. 2011 Jun;93(6):824-7. doi: 10.1302/0301-620X.93B6.23144.
Biofilm-associated infections in wounds or on implants are difficult to treat. Eradication of the bacteria is nearly always impossible, despite the use of specific antibiotics. The bactericidal effects of high-energy extracorporeal shock waves on Staphylococcus aureus have been reported, but the effect of low-energy shock waves on staphylococci and staphylococcal biofilms has not been investigated. In this study, biofilms grown on stainless steel washers were examined by electron microscopy. We tested ten experimental groups with Staph. aureus-coated washers and eight groups with Staph. epidermidis. The biofilm-cultured washers were exposed to low-energy shock waves at 0.16 mJ/mm(2) for 500 impulses. The washers were then treated with cefuroxime, rifampicin and fosfomycin, both alone and in combination. All tests were carried out in triplicate. Viable cells were counted to determine the bactericidal effect. The control groups of Staph. aureus and Staph. epidermidis revealed a cell count of 6 × 10(8) colony-forming units/ml. Complete eradication was achieved using the combination of antibiotic therapy (single antibiotic in Staph. aureus, a combination in Staph. epidermidis) and shock wave application (p < 0.01). We conclude that shock waves combined with antibiotics could be tested in an in vitro model of infection.
伤口或植入物上的生物膜相关感染难以治疗。尽管使用了特定抗生素，但几乎总是无法根除细菌。已有报道高能体外冲击波对金黄色葡萄球菌有杀菌作用，但低能冲击波对葡萄球菌和葡萄球菌生物膜的作用尚未研究。在本研究中，通过电子显微镜检查了在不锈钢垫圈上生长的生物膜。我们测试了十个用金黄色葡萄球菌包被垫圈的实验组和八个用表皮葡萄球菌的实验组。将生物膜培养的垫圈暴露于0.16 mJ/mm(2) 的低能冲击波下500次脉冲。然后将垫圈分别单独或联合用头孢呋辛、利福平和磷霉素处理。所有测试均重复三次。通过计数活细胞来确定杀菌效果。金黄色葡萄球菌和表皮葡萄球菌的对照组显示细胞计数为6×10(8) 菌落形成单位/毫升。使用抗生素治疗（金黄色葡萄球菌用单一抗生素，表皮葡萄球菌用联合抗生素）和冲击波应用的组合实现了完全根除（p<0.01）。我们得出结论，冲击波联合抗生素可在体外感染模型中进行测试。
