Hill Derek L, Castiaux Andre, Pensler Elizabeth, Knue Joseph, Attar Paul S, Siddiqi Ahmed
AZ Solutions, LLC, Ferndale, Michigan.
Michigan State University College of Osteopathic Medicine, East Lansing, Michigan.
Surg Technol Int. 2022 Nov 15;41:17-23. doi: 10.52198/22.STI.41.SO1595.
The search for the optimal agent for infection eradication in periprosthetic joint infection (PJI) remains challenging as there are limited efficacious and safe options. The ideal solution should have significant bactericidal and anti-biofilm activity to be able to eradicate infection with the preservation of prosthetic components. Therefore, the purpose of this study was to 1) investigate the anti-biofilm efficacy of a novel activated zinc solution against Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) biofilm in vitro and 2) compare its efficacy against two leading commercially available antimicrobial irrigants (CHG and 0.35% povidone-iodine [PI]).
A modified Robbins device (MRD) was utilized to replicate Pseudomonas aeruginosa and MRSA biofilms. The primary outcome was to determine bacterial reduction after two hours of biofilm exposure to an activated zinc solution, CHG, and PI, and compare to untreated controls.
Against Pseudomonas biofilm, activated zinc demonstrated a 4.5-log (99.996%) reduction, chlorhexidine demonstrated a 0.9-log (87.4%) reduction (p<0.001), and PI demonstrated a 0.8-log (83.1%) reduction (p<0.001). After two hours of exposure, activated zinc had undetectable MRSA with a 7.08-log (100%) reduction, chlorhexidine had a 1.9-log (98.7%) reduction (p<0.01), and PI had a 3.2-log (99.9%) reduction (p<0.01).
Our novel activated zinc compound demonstrated a 99.996% reduction in Pseudomonas biofilm and a 100% reduction in MRSA biofilm. This novel solution may provide a significant tool in the arsenal to treat and/or prevent PJI and other wound infections. Future in vivo studies are warranted to demonstrate clinical utility, efficacy, and safety.
由于有效且安全的选择有限，寻找用于根除人工关节周围感染（PJI）的最佳药物仍然具有挑战性。理想的解决方案应具有显著的杀菌和抗生物膜活性，以便能够在保留假体组件的情况下根除感染。因此，本研究的目的是：1）在体外研究一种新型活性锌溶液对铜绿假单胞菌和耐甲氧西林金黄色葡萄球菌（MRSA）生物膜的抗生物膜功效；2）将其功效与两种领先的市售抗菌冲洗剂（洗必泰葡萄糖酸盐[CHG]和0.35%聚维酮碘[PI]）进行比较。
使用改良的罗宾斯装置（MRD）来复制铜绿假单胞菌和MRSA生物膜。主要结果是确定生物膜暴露于活性锌溶液、CHG和PI两小时后的细菌减少情况，并与未处理的对照进行比较。
对于铜绿假单胞菌生物膜，活性锌使细菌减少了4.5个对数（99.996%），洗必泰葡萄糖酸盐使细菌减少了0.9个对数（87.4%）（p<0.001），PI使细菌减少了0.8个对数（83.1%）（p<0.001）。暴露两小时后，活性锌使MRSA无法检测到，减少了7.08个对数（100%），洗必泰葡萄糖酸盐减少了1.9个对数（98.7%）（p<0.01），PI减少了3.2个对数（99.9%）（p<0.01）。
我们的新型活性锌化合物使铜绿假单胞菌生物膜减少了99.996%，使MRSA生物膜减少了100%。这种新型溶液可能为治疗和/或预防PJI及其他伤口感染提供一种重要工具。未来有必要进行体内研究以证明其临床实用性、疗效和安全性。
