Department of Orthopaedics, First Hospital of Jiaxing, South Central Avenue No. 1882, Jiaxing, 314000, People's Republic of China.
College of Medicine, Jiaxing University, Guangqiong Avenue No. 899, Jiaxing, 314000, People's Republic of China.
J Orthop Surg Res. 2023 Oct 5;18(1):756. doi: 10.1186/s13018-023-04246-x.
Iodophors are known to be a treatment for biofilm-related periprosthetic joint infection. However, the efficacy and mechanism of eradicating biofilms from different artificial joint materials after iodophor treatment are unknown. This study was conducted to understand the effect and mechanism of iodophors with respect to the adhesion and virulence of Staphylococcus aureus biofilms attached to artificial joint materials.
Biofilms of Staphylococcus aureus strains were grown on titanium alloy, cobalt chromium molybdenum and polyethylene coupons, which are commonly used materials for artificial joints, for 24 h. Afterward, all coupons were divided into experimental and control groups: (1) exposed to a 0.5 ± 0.05% iodophor for 5 min and (2) exposed to phosphate-buffered saline for 5 min. To gauge the level of biofilm, colony forming units (CFU), live/dead staining confocal microscopy and crystal violet staining were used. Meanwhile, the expression of icaACDR and clfA, which are related to virulence and adhesion, was examined in both the experimental and control groups.
A roughly three-log decrease in CFU/cm was seen in the viable plate count compared to the control group. Confocal imaging and crystal violet staining verified the CFU data. Moreover, the expression of icaACDR was reduced on three different orthopaedic implant materials, and the expression of clfA was also inhibited on titanium alloy coupons exposed to the iodophor.
Our results indicated that exposure to an iodophor for 5 min could significantly eliminate biofilms. When Staphylococcus aureus that had adhered to these three materials, which were used for artificial joints, was treated with an iodophor for 5 min, the expression of icaACDR was significantly reduced. This provides strong evidence for clinically clearing periprosthetic joint infections without removing the artificial joints.
已知碘伏是治疗生物膜相关人工关节感染的一种方法。然而，碘伏处理不同人工关节材料后清除生物膜的效果和机制尚不清楚。本研究旨在了解碘伏对附着在人工关节材料上的金黄色葡萄球菌生物膜的黏附力和毒力的影响及其作用机制。
将金黄色葡萄球菌菌株生物膜在钛合金、钴铬钼和聚乙烯试片上培养 24 小时，这些试片是人工关节常用材料。之后，所有试片被分为实验组和对照组：（1）用 0.5±0.05%的碘伏处理 5 分钟；（2）用磷酸盐缓冲液处理 5 分钟。为了评估生物膜的水平，采用了菌落形成单位（CFU）、活/死染色共聚焦显微镜和结晶紫染色法。同时，在实验组和对照组中检测了与毒力和黏附力相关的 icaACDR 和 clfA 的表达情况。
与对照组相比，活菌平板计数的 CFU/cm 减少了约三个对数级。共聚焦成像和结晶紫染色验证了 CFU 数据。此外，在三种不同的骨科植入材料上，icaACDR 的表达减少，暴露于碘伏的钛合金试片上 clfA 的表达也受到抑制。
我们的结果表明，碘伏处理 5 分钟可显著清除生物膜。当金黄色葡萄球菌附着在这三种用于人工关节的材料上时，用碘伏处理 5 分钟可显著降低 icaACDR 的表达。这为临床上在不取出人工关节的情况下清除人工关节周围感染提供了有力证据。
