Tsang S T J, Gwynne P J, Gallagher M P, Simpson A H R W
Department of Orthopaedic Surgery and School of Biological Sciences, University of Edinburgh, Edinburgh, UK.
School of Biological Sciences, University of Edinburgh, Edinburgh, UK.
Bone Joint Res. 2018 Sep 15;7(8):517-523. doi: 10.1302/2046-3758.78.BJR-2018-0045.R1. eCollection 2018 Aug.
Periprosthetic joint infection following joint arthroplasty surgery is one of the most feared complications. The key to successful revision surgery for periprosthetic joint infections, regardless of treatment strategy, is a thorough deep debridement. In an attempt to limit antimicrobial and disinfectant use, there has been increasing interest in the use of acetic acid as an adjunct to debridement in the management of periprosthetic joint infections. However, its effectiveness in the eradication of established biofilms following clinically relevant treatment times has not been established. Using an biofilm model, this study aimed to establish the minimum biofilm eradication concentration (MBEC) of acetic acid following a clinically relevant treatment time.
Using a methicillin-sensitive (MSSA) reference strain and the dissolvable bead assay, biofilms were challenged by 0% to 20% acetic acid (pH 4.7) for ten minutes, 20 minutes, 180 minutes, and 24 hours.
The MBEC of acetic acid was found to be: 15%, 11%, 3.2%, and 0.8% following a ten-minute, 20-minute, 180-minute, and 24-hour treatment, respectively.
This study found that the MBEC of acetic acid following a 10- or 20-minute treatment time exceeded its safety threshold, making these concentrations unsuitable as a topical debridement adjunct. However, a clinically acceptable concentration (5%) was still found to eliminate 96.1% of biofilm-associated MSSA following a 20-minute treatment time.: S. T. J. Tsang, P. J. Gwynne, M. P. Gallagher, A. H. R. W. Simpson. The biofilm eradication activity of acetic acid in the management of periprosthetic joint infection. 2018;7:517-523. DOI: 10.1302/2046-3758.78.BJR-2018-0045.R1.
关节置换术后假体周围关节感染是最令人担忧的并发症之一。无论采用何种治疗策略，假体周围关节感染翻修手术成功的关键在于彻底的深部清创。为了限制抗菌药物和消毒剂的使用，人们越来越关注使用醋酸作为假体周围关节感染清创辅助手段。然而，在临床相关治疗时间后，其根除已形成生物膜的有效性尚未得到证实。本研究使用生物膜模型，旨在确定临床相关治疗时间后醋酸的最低生物膜根除浓度（MBEC）。
使用对甲氧西林敏感的金黄色葡萄球菌（MSSA）参考菌株和可溶解微珠试验，用0%至20%的醋酸（pH 4.7）对生物膜进行10分钟、20分钟、180分钟和24小时的挑战。
醋酸的MBEC分别为：10分钟、20分钟、180分钟和24小时治疗后的15%、11%、3.2%和0.8%。
本研究发现，10分钟或20分钟治疗时间后醋酸的MBEC超过其安全阈值，因此这些浓度不适合作为局部清创辅助剂。然而，在20分钟治疗时间后，仍发现临床可接受的浓度（5%）可消除96.1%的与生物膜相关的MSSA。：S. T. J. 曾，P. J. 格温，M. P. 加拉格尔，A. H. R. W. 辛普森。醋酸在假体周围关节感染管理中的生物膜根除活性。2018年；7:517 - 523。DOI: 10.1302/2046 - 3758.78.BJR - 2018 - 0045.R1。
