Hospital Universitário Cajuru - HUC, Spine Department. Pontifícia, Universidade Católica do Paraná (PUCPR), Avenida São José, 300, Curitiba, Paraná, 80050-350, Brazil.
School of Medicine, Health Sciences Department, Pontifícia Universidade Católica do Paraná (PUCPR), Rua Imaculada Conceição, 1155, Curitiba, Paraná, 80215-901, Brazil.
Eur J Orthop Surg Traumatol. 2022 Jul;32(5):981-989. doi: 10.1007/s00590-021-03069-y. Epub 2021 Jul 8.
Titanium and polyether-ether-ketone (PEEK) interbody cages are commonly used for spine fusion. Few data are known about bacterial and yeast biofilms formation in these implants. The aim of this study was to compare Staphylococcus aureus and Candida albicans biofilm formation in the surface of two different interbody devices used routinely in spine surgery.
Six bodies of proof specimens of PEEK and titanium alloy were used for microbiological tests, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. Experimental biofilm was produced with Staphylococcus aureus and Candida albicans, followed by quantitative analysis of planktonic cells and sessile cells. The comparison between the medians of biofilm quantification between the two models was performed using the Mann-Whitney test and considered the statistical difference for a p < 0.05.
In the S. aureus model, in both planktonic and sessile cell counts, titanium-alloy samples showed lower values for colony forming units per milliliter (UFC/mL) (p < 0.05). The evaluation through the optic density of planktonic and sessile cells showed lower values in the titanium-alloy samples, however, only statistically significant in planktonic cell count (p < 0.05). The count of planktonic yeast cells in PEEK was similar to titanium-alloy samples, while the count of sessile yeast cells in titanium alloy was lower when compared to PEEK (p < 0.05).
Titanium-alloy models were associated with less staphylococcal and Candida biofilm formation when compared with PEEK.
钛和聚醚醚酮（PEEK）椎间融合器常用于脊柱融合。关于这些植入物中细菌和酵母生物膜形成的数据很少。本研究的目的是比较两种常规用于脊柱手术的不同椎间融合器表面金黄色葡萄球菌和白色念珠菌生物膜的形成。
使用 6 个 PEEK 和钛合金的实物标本进行微生物学测试、扫描电子显微镜和能量色散 X 射线光谱分析。用金黄色葡萄球菌和白色念珠菌生成实验性生物膜，然后对浮游细胞和固着细胞进行定量分析。使用 Mann-Whitney 检验比较两种模型之间生物膜定量的中位数，并认为 p<0.05 时有统计学差异。
在金黄色葡萄球菌模型中，钛合金样品的浮游和固着细胞计数的菌落形成单位数（UFC/mL）均较低（p<0.05）。通过浮游和固着细胞的光密度评估，钛合金样品的数值较低，但仅在浮游细胞计数中具有统计学意义（p<0.05）。PEEK 中的浮游酵母细胞计数与钛合金样品相似，而钛合金中的固着酵母细胞计数低于 PEEK（p<0.05）。
与 PEEK 相比，钛合金模型与较少的金黄色葡萄球菌和白色念珠菌生物膜形成有关。
