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骨水泥型假体相关骨髓炎中外源凝固酶阴性葡萄球菌和肠球菌的生物膜形成和抗菌药物敏感性。

Biofilm formation and antimicrobial susceptibility of staphylococci and enterococci from osteomyelitis associated with percutaneous orthopaedic implants.

机构信息

Biomatcell Vinn Excellence Center of Biomaterials and Cell Therapy, PO Box 412, 405 30, Gothenburg, Sweden.

Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

J Biomed Mater Res B Appl Biomater. 2017 Nov;105(8):2630-2640. doi: 10.1002/jbm.b.33803. Epub 2016 Oct 25.


DOI:10.1002/jbm.b.33803
PMID:27779811
Abstract

Staphylococci and enterococci account for most deep infections associated with bone-anchored percutaneous implants for amputation treatment. Implant-associated infections are difficult to treat; therefore, it is important to investigate if these infections have a biofilm origin and to determine the biofilm antimicrobial susceptibility to improve treatment strategies. The aims were: (i) to test a novel combination of the Calgary biofilm device and a custom-made susceptibility MIC plate (Sensititre ), (ii) to determine the biofilm formation and antimicrobial resistance in clinical isolates causing implant-associated osteomyelitis, and (iii) to describe the associated clinical outcome. Enterococci and staphylococci were characterized by microtitre plate assay, Congo Red Agar plate test, and PCR. Biofilm susceptibility to 10 antimicrobials and its relationship to treatment outcomes were determined. The majority of the strains produced biofilm in vitro showing inter- and intraspecies differences. Biofilms showed a significantly increased antimicrobial resistance compared with their planktonic counterparts. Slime-producing strains tolerated significantly higher antimicrobial concentrations compared with non-producers. All seven staphylococcal strains carried ica genes, but two did not produce slime. The degree of biofilm formation and up-regulated antibiotic resistance may translate into a variable risk of treatment failure. This new method set-up allows for the reproducible determination of minimum biofilm eradication concentration of antimicrobial agents, which may guide future antimicrobial treatment decisions in orthopaedic implant-associated infection. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2630-2640, 2017.

摘要

葡萄球菌和肠球菌是与截肢治疗用骨锚定经皮植入物相关的大多数深部感染的主要病原体。与植入物相关的感染很难治疗;因此,研究这些感染是否源于生物膜并确定生物膜对抗微生物药物的敏感性以改善治疗策略非常重要。目的是:(i)测试 Calgary 生物膜设备和定制药敏 MIC 板(Sensititre)的新组合,(ii)确定引起植入物相关骨髓炎的临床分离物的生物膜形成和抗菌耐药性,(iii)描述相关的临床结果。肠球菌和葡萄球菌通过微量滴定板测定、刚果红琼脂板试验和 PCR 进行鉴定。确定了 10 种抗菌药物对生物膜的敏感性及其与治疗结果的关系。大多数菌株在体外产生生物膜,表现出种间和种内差异。生物膜的抗菌耐药性明显高于浮游细胞。与非产粘液菌株相比,产粘液菌株耐受的抗菌药物浓度明显更高。所有 7 株葡萄球菌均携带 ica 基因,但有 2 株不产粘液。生物膜形成程度和上调的抗生素耐药性可能转化为治疗失败的风险变化。这种新的方法设置允许重现性地确定最低生物膜清除浓度的抗菌药物,这可能指导未来骨科植入物相关感染的抗菌治疗决策。© 2016 Wiley Periodicals, Inc. J 生物医学材料研究杂志 B:应用生物材料,105B:2630-2640,2017 年。

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[10]
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