Ernest Emily P, Machi Anthony S, Karolcik Brock A, LaSala Paul R, Dietz Matthew J
Robert C. Byrd Health Sciences Center, Department of Orthopaedics, West Virginia University School of Medicine, P.O. Box 9196, Morgantown, West Virginia, 26506-9196.
Robert C. Byrd Health Sciences Center, West Virginia University School of Medicine, P.O. Box 9100, Morgantown, West Virginia, 26506-9100.
J Orthop Res. 2018 Jun;36(6):1599-1604. doi: 10.1002/jor.23804. Epub 2017 Nov 30.
Adjuvant treatments including Betadine, Dakin's solution (sodium hypochlorite), or hydrogen peroxide (H O ) have been attempted to eradicate prosthetic joint infection caused by biofilm or intracellular bacteria. The purpose of this study was to evaluate the in vitro abilities of chemical adjuvants to decrease Staphylococcus aureus (S. aureus) biofilm presence on orthopaedic implant grade materials, including titanium, stainless steel, and cobalt chrome. S. aureus biofilms were grown for 48 h and evaluated for baseline colony forming units/centimeter squared (CFU/cm ) and compared to treatments with Betadine, Dakin's solution, H O , or 1% chlorine dioxide (ClO ). Control discs (n = 18) across all metals had an average of 4.2 × 10 CFU/cm . All treatments had statistically significant reductions in CFU/cm when compared to respective control discs (p < 0.05). For all metals combined, the most efficacious treatments were Betadine and H O , with an average 98% and 97% CFU/cm reduction, respectively. There were no significant differences between reductions seen with Betadine and H O , but both groups had statistically greater reductions than Dakin's solution and ClO . There was no change in antibiotic resistance patterns after treatment. Analysis of S. aureus biofilms demonstrated a statistically significant reduction in biofilm after a five-minute treatment with the modalities, with an average two log reduction in CFU/cm . Statement of clinical significance: While statistically significant reductions in CFU/cm were accomplished with chemical adjuvant treatments, the overall concentration of bacteria never fell below 10 CFU/cm , leading to questionable clinical significance. Further techniques to eradicate biofilm should be investigated. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1599-1604, 2018.
已尝试使用包括碘伏、达金氏溶液（次氯酸钠）或过氧化氢（H₂O₂）在内的辅助治疗方法来根除由生物膜或细胞内细菌引起的人工关节感染。本研究的目的是评估化学辅助剂在体外降低金黄色葡萄球菌（S. aureus）在骨科植入级材料（包括钛、不锈钢和钴铬合金）上形成生物膜的能力。金黄色葡萄球菌生物膜生长48小时，并评估其基线菌落形成单位/平方厘米（CFU/cm²），并与用碘伏、达金氏溶液、H₂O₂或1%二氧化氯（ClO₂）处理后的情况进行比较。所有金属的对照圆盘（n = 18）平均有4.2×10⁵ CFU/cm²。与各自的对照圆盘相比，所有处理的CFU/cm²均有统计学显著降低（p < 0.05）。对于所有金属综合来看，最有效的处理方法是碘伏和H₂O₂，平均CFU/cm²降低分别为98%和97%。碘伏和H₂O₂处理后的降低效果之间没有显著差异，但两组在统计学上的降低幅度均大于达金氏溶液和ClO₂。处理后抗生素耐药模式没有变化。对金黄色葡萄球菌生物膜的分析表明，用这些方法处理五分钟后，生物膜有统计学显著减少，CFU/cm²平均减少两个对数。临床意义声明：虽然化学辅助治疗在统计学上显著降低了CFU/cm²，但细菌的总体浓度从未降至10³ CFU/cm²以下，导致临床意义存疑。应研究根除生物膜的进一步技术。© 2017骨科研究协会。由威利期刊公司出版。《矫形外科学研究》36:1599 - 1604，2018年。
