Dudek Bartłomiej, Brożyna Malwina, Karoluk Michał, Frankiewicz Mariusz, Migdał Paweł, Szustakiewicz Konrad, Matys Tomasz, Wiater Adrian, Junka Adam
"P.U.M.A.", Platform for Unique Model Application, Department of Pharmacy, Wroclaw Medical University, Borowska 211, 50-534 Wroclaw, Poland.
Faculty of Mechanical Engineering, Department of Laser Technologies, Automation and Production Organization, Wrocław University of Science and Technology, Ignacego Łukasiewicza 5, 50-371 Wroclaw, Poland.
Int J Mol Sci. 2024 Nov 26;25(23):12720. doi: 10.3390/ijms252312720.
The growing antibiotic resistance of microorganisms causing postoperative infections following orthopedic surgeries underscores the urgent need for localized antiseptic and lavage delivery systems to enhance infection control. This study evaluates the in vitro effectiveness of antiseptic and lavage solutions-including polyhexanide, povidone-iodine, low-concentrated hypochlorite, Ringer's solution, and saline-against , MRSA, , , , and . Using microplate models (Minimum Inhibitory Concentration, Minimum Biofilm Eradication Concentration, and Biofilm-Oriented Antiseptic Test assays), flow-based models (Bioflux system), and surfaces relevant to orthopedic implants (e.g., stainless steel disks/screws, Co-Cr-Mo, Ti-Al-Nb orthopedic alloys, and ultra-high-molecular-weight polyethylene), as well as a bio-nano-cellulose scaffold representing tissue, we assessed the solutions' activity. The cytotoxicity of the solutions was evaluated using osteoblast and keratinocyte cell lines, with additional in vivo insights gained through the larval model. The results show that polyhexanide-based solutions outperformed povidone-iodine in biofilm eradication in most tests applied, particularly on complex surfaces, whereas iodine demonstrated higher cytotoxicity in applied in vitro and in vivo tests. Low-concentration hypochlorite solutions exhibited minimal antibiofilm activity but also showed no cytotoxicity in cell line and larval models. These findings highlight the importance of careful antiseptic selection and rinsing protocols to balance infection control efficacy with tissue compatibility in orthopedic applications.
骨科手术后引起术后感染的微生物对抗生素的耐药性不断增强，这凸显了对局部抗菌和灌洗给药系统的迫切需求，以加强感染控制。本研究评估了包括聚己缩胍、聚维酮碘、低浓度次氯酸盐、林格氏液和生理盐水在内的抗菌和灌洗溶液对耐甲氧西林金黄色葡萄球菌（MRSA）、表皮葡萄球菌、金黄色葡萄球菌、大肠杆菌和铜绿假单胞菌的体外有效性。我们使用微孔板模型（最低抑菌浓度、最低生物膜根除浓度和生物膜导向抗菌测试分析）、基于流动的模型（Bioflux系统）以及与骨科植入物相关的表面（如不锈钢盘/螺钉、钴铬钼、钛铝铌骨科合金和超高分子量聚乙烯），以及代表组织的生物纳米纤维素支架，评估了这些溶液的活性。使用成骨细胞和角质形成细胞系评估溶液的细胞毒性，并通过斑马鱼幼虫模型获得额外的体内见解。结果表明，在大多数应用测试中，尤其是在复杂表面上，基于聚己缩胍的溶液在生物膜根除方面优于聚维酮碘，而碘在体外和体内应用测试中表现出更高的细胞毒性。低浓度次氯酸盐溶液表现出最小的抗生物膜活性，但在细胞系和斑马鱼幼虫模型中也未显示出细胞毒性。这些发现强调了在骨科应用中仔细选择抗菌剂和冲洗方案以平衡感染控制效果与组织相容性的重要性。
