Al Ghaithi Ahmed, Husband John, Al Bimani Attika, Al Kindi Mohammed, Al Maskari Sultan
Departments of Surgery, Sultan Qaboos University, Muscat, Oman.
Departments of Chemistry, Sultan Qaboos University, Muscat, Oman.
Sultan Qaboos Univ Med J. 2025 May 2;25(1):98-104. doi: 10.18295/squmj.10.2024.053. eCollection 2025.
Osteomyelitis, characterised by bone inflammation due to microbial infection, presents significant healthcare challenges. While the protective role of biofilm in bacterial immunity and persistence is well-documented, its direct impact on bone degradation in osteomyelitis remains inadequately characterised. This study aimed to comprehensively examine the direct effects of biofilm-forming pathogens on human bone, providing new insights into the mechanisms of bone destruction associated with osteomyelitis.
Bone sections were collected from patients undergoing total knee replacement surgery at Sultan Qaboos University Hospital, Muscat, Oman, between January 2021 and December 2022. The samples were then inoculated with to simulate bone infection. Raman spectroscopy and scanning electron microscopy (SEM) were employed to analyse the bacterial interaction with bone tissue.
Biofilm-forming pathogens directly contributed to bone degradation, as evidenced by SEM images showing marked trabecular destruction. Raman analysis showed a significant increase in the carbonate-to-phosphate ratio in inoculated samples (61.9%) compared to controls (47%). Additionally, mineral content decreased in inoculated samples, and the carbonate-to-amide I ratio reduced by 47% in inoculated samples and by 80% in controls. The inoculated samples exhibited an 82% shift in collagen cross-linking compared to a 72% shift in controls.
This research enhances the comprehension of the mechanisms underlying bone destruction in osteomyelitis and underscores the intricate role of biofilm in disease progression. These findings highlight the importance of biofilm in bone degradation and its potential implications for infection management.
骨髓炎以微生物感染引起的骨炎症为特征，带来了重大的医疗挑战。虽然生物膜在细菌免疫和持续存在中的保护作用已得到充分证明，但其对骨髓炎中骨降解的直接影响仍未得到充分描述。本研究旨在全面检查形成生物膜的病原体对人骨的直接影响，为与骨髓炎相关的骨破坏机制提供新的见解。
收集2021年1月至2022年12月期间在阿曼马斯喀特苏丹卡布斯大学医院接受全膝关节置换手术患者的骨切片。然后将样本接种以模拟骨感染。采用拉曼光谱和扫描电子显微镜（SEM）分析细菌与骨组织的相互作用。
扫描电子显微镜图像显示明显的小梁破坏，证明形成生物膜的病原体直接导致骨降解。拉曼分析显示接种样本中的碳酸盐与磷酸盐比率（61.9%）相比对照组（47%）有显著增加。此外，接种样本中的矿物质含量降低，接种样本中的碳酸盐与酰胺I比率降低了47%，对照组降低了80%。与对照组72%的变化相比，接种样本的胶原蛋白交联变化了82%。
本研究增强了对骨髓炎中骨破坏潜在机制的理解，并强调了生物膜在疾病进展中的复杂作用。这些发现突出了生物膜在骨降解中的重要性及其对感染管理的潜在影响。
