1
|
Hu Z, Yin X, Fan G, Liao X. Global Trends in Orthopedic Biofilm Research: A Bibliometric Analysis of 1994-2022. J Multidiscip Healthc 2024; 17:3057-3069. [PMID: 38974376 PMCID: PMC11227867 DOI: 10.2147/jmdh.s465632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/15/2024] [Indexed: 07/09/2024] Open
Abstract
Objective Bibliometric analysis is commonly used to visualize the knowledge foundation, trends, and patterns in a specific scientific field by performing a quantitative evaluation of the relevant literature. The purpose of this study was to perform a bibliometric analysis of recent studies in the field of orthopedic biofilm research and identify its current trends and hotspots. Methods Research studies were retrieved from the Web of Science Core Collection and Scopus databases and analyzed in bibliometrix with R package (4.2.2). Results A total of 2426 literature were included in the study. Journal of orthopaedic research and Clinical orthopaedics and related research ranked first in terms of productivity and impact, with 57 published articles and 32 h-index, respectively. Trampuz A, Ohio State Univ and the United States ranked as the most productive authors, institutions, and countries. Biofilm formation, role of sonication, biomaterial mechanism and antibiotic loading have been investigated as the trend and hotspots in the field of orthopedic biofilm research. Conclusion This study provides a thorough overview of the state of the art of current orthopedic biofilm research and offers valuable insights into recent trends and hotspots in this field.
Collapse
Affiliation(s)
- Zhouyang Hu
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, People’s Republic of China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, People’s Republic of China
| | - Xiaobing Yin
- Nursing Department, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China
| | - Guoxin Fan
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, People’s Republic of China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, People’s Republic of China
| | - Xiang Liao
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, People’s Republic of China
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen, 518060, People’s Republic of China
| |
Collapse
|
2
|
Doub JB, Levack AE, Sands L, Blommer J, Fackler J, O'Toole RV. Feasibility of using bacteriophage therapy to treat Staphylococcal aureus fracture-related infections. Injury 2024; 55:111442. [PMID: 38387121 DOI: 10.1016/j.injury.2024.111442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE Staphylococcus aureus fracture-related infections (FRIs) are associated with significant morbidity in part because conventional antibiotic therapies have limited ability to eradicate S. aureus in sessile states. Therefore, the objective of this study was to assess the feasibility of using Staphylococcal bacteriophages for FRI by testing the activity of a library of Staphylococcal bacteriophage therapeutics against historically preserved S. aureus FRI clinical isolates. METHODS Current Procedural Terminology codes were used to identify patients with FRI from January 1, 2021 to December 31, 2021. Preserved S. aureus FRI isolates from the cases were then tested against a library of 51 Staphylococcal bacteriophages from an American company. This was conducted by assessing the ability of bacteriophages to reduce bacterial growth over time. Growth inhibition greater than 16 h was considered adequate for this study. RESULTS All of the S. aureus preserved clinical isolates had at least one bacteriophage with robust lytic activity and six bacteriophages (11.8 %) had robust lytic activity to seven or more of the clinical isolates. However, 41 of the bacteriophages (80.4 %) had activity to less than three of the clinical isolates and no bacteriophage had activity to all the clinical isolates. CONCLUSION Our findings show that Staphylococcal bacteriophage therapeutics are readily available for S. aureus FRI clinical isolates. However, when correlated with the current barriers to using bacteriophages to treat FRI, designated Staphylococcal bacteriophage cocktails with broad spectrum activity should be created.
Collapse
Affiliation(s)
- James B Doub
- The Doub Laboratory of Translational Bacterial Research, University of Maryland School of Medicine, Baltimore, MD, United States; Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States.
| | - Ashley E Levack
- Department of Orthopaedic Surgery & Rehabilitation, Loyola University Medical Center, Maywood, IL, United States
| | - Lauren Sands
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - Joseph Blommer
- University of Maryland School of Medicine, Baltimore, MD, United States
| | - Joseph Fackler
- Adaptive Phage Therapeutics, Gaithersburg, MD, United States
| | - Robert V O'Toole
- Department of Orthopaedic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States
| |
Collapse
|
3
|
Goudot S, Mathieu L, Herbelin P, Soreau S, Jorand FPA. Growth dynamic of biofilm-associated Naegleria fowleri in freshwater on various materials. Front Microbiol 2024; 15:1369665. [PMID: 38511008 PMCID: PMC10951111 DOI: 10.3389/fmicb.2024.1369665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/08/2024] [Indexed: 03/22/2024] Open
Abstract
In industrial water systems, the occurrence of biofilm-associated pathogenic free-living amoebae (FLA) such as Naegleria fowleri is a potential hygienic problem, and factors associated with its occurrence remain poorly understood. This study aimed to evaluate the impact of four cooling circuit materials on the growth of N. fowleri in a freshwater biofilm formed at 42°C and under a hydrodynamic shear rate of 17 s-1 (laminar flow): polyvinyl chloride, stainless steel, brass, and titanium. Colonization of the freshwater biofilms by N. fowleri was found to be effective on polyvinyl chloride, stainless steel, and titanium. For these three materials, the ratio of (bacterial prey)/(amoeba) was found to control the growth of N. fowleri. All materials taken together, a maximum specific growth rate of 0.18 ± 0.07 h-1 was associated with a generation time of ~4 h. In contrast, no significant colonization of N. fowleri was found on brass. Therefore, the contribution of copper is strongly suspected.
Collapse
Affiliation(s)
- Sébastien Goudot
- EDF Recherche et Développement, Laboratoire National d'Hydraulique et Environnement, Chatou, France
- Université de Lorraine, CNRS, LCPME, Nancy, France
| | | | - Pascaline Herbelin
- EDF Recherche et Développement, Laboratoire National d'Hydraulique et Environnement, Chatou, France
| | - Sylvie Soreau
- EDF Recherche et Développement, Laboratoire National d'Hydraulique et Environnement, Chatou, France
| | | |
Collapse
|
4
|
Mas-Celis F, Olea-López J, Parroquin-Maldonado JA. Sepsis in Trauma: A Deadly Complication. Arch Med Res 2021; 52:808-816. [PMID: 34706851 DOI: 10.1016/j.arcmed.2021.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/12/2021] [Accepted: 10/15/2021] [Indexed: 11/28/2022]
Abstract
Sepsis is a major cause of death following a traumatic injury. As a life-threatening medical emergency, it is defined as the body's extreme response to an infection. Without timely treatment, sepsis can rapidly lead to tissue damage, and organ failure The capacity to limit tissue damage through metabolic adaptation and repair processes is associated with an excessive immune response of the host. It is important to make an early prediction of sepsis, based on the quick Sepsis associated Organ Failure Assessment Score (qSOFA), so an accurate treatment can be initiated reducing the morbidity and mortality at the emergency and UCI services. Many factors increase the rate of complications and the development of sepsis in a trauma patient, representing a challenge to orthopedic surgeons. Several early biomarkers that help to identify and predict the inflammatory and immune responses of the host going through polytrauma and sepsis have been studied; procalcitonin (PCT), C-reactive protein (CRP), glycosylated hemoglobin (HbA1c), the Neutrophil/lymphocyte ratio (NLR), Interleukin-17 (IL-17), Caspase-1, Vanin-1, High-density lipoproteins (HDL), and the Thrombin-activable fibrinolysis inhibitor (TAFI). Once sepsis is diagnosed, treatment must be immediately initiated with an appropriate empiric antimicrobial, an all-purpose supporting treatment, and metabolic control, followed by the specific antibiotic therapy based on blood culture. Since the participation of sepsis in polytrauma has been recognized as a key event in the outcome of patients at the ICU, the ability of the specialist to early recognize a septic process has become a key feature to reduce mortality and improve clinical prognosis.
Collapse
Affiliation(s)
- Fernanda Mas-Celis
- Departamento de Ortopedia y Traumatología, Hospital Angeles del Pedregal, Ciudad de México, México.
| | - Jimena Olea-López
- Departamento de Ortopedia y Traumatología, Hospital Angeles del Pedregal, Ciudad de México, México
| | | |
Collapse
|
5
|
Hong Q, Huo S, Tang H, Qu X, Yue B. Smart Nanomaterials for Treatment of Biofilm in Orthopedic Implants. Front Bioeng Biotechnol 2021; 9:694635. [PMID: 34589470 PMCID: PMC8473796 DOI: 10.3389/fbioe.2021.694635] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 07/23/2021] [Indexed: 01/02/2023] Open
Abstract
Biofilms refer to complex bacterial communities that are attached to the surface of animate or inanimate objects, which highly resist the antibiotics or the host immune defense mechanisms. Pathogenic biofilms in medicine are general, chronic, and even costly, especially on medical devices and orthopedic implants. Bacteria within biofilms are the cause of many persistent infections, which are almost impossible to eradicate. Though some progress has been made in comprehending the mechanisms of biofilm formation and persistence, novel alternative compounds or strategies and effective anti-biofilm antibiotics are still lacking. Smart materials of nano size which are able to respond to an external stimulus or internal environment have a great range of applications in clinic. Recently, smart nanomaterials with or without carriage of antibiotics, targeting specific bacteria and biofilm under some stimuli, have shown great potential for pathogenic biofilm and resident bacteria eradication. First, this review briefly summarizes and describes the significance of biofilms and the process of biofilm formation. Then, we focus on some of the latest research studies involving biofilm elimination, which probably could be applied in orthopedic implants. Finally, some outstanding challenges and limitations that need to be settled urgently in order to make smart nanomaterials effectively target and treat implant biofilms are also discussed. It is hoped that there will be more novel anti-biofilm strategies for biofilm infection in the prospective future.
Collapse
Affiliation(s)
| | | | | | - Xinhua Qu
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Bing Yue
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
6
|
Kheir MM, Dilley JE, Ziemba-Davis M, Meneghini RM. The AAHKS Clinical Research Award: Extended Oral Antibiotics Prevent Periprosthetic Joint Infection in High-Risk Cases: 3855 Patients With 1-Year Follow-Up. J Arthroplasty 2021; 36:S18-S25. [PMID: 33589279 PMCID: PMC9161732 DOI: 10.1016/j.arth.2021.01.051] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/05/2021] [Accepted: 01/19/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Surgical and host factors predispose patients to periprosthetic joint infection (PJI) after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). While surgical factors are modifiable, host factors can be challenging, and there are limited data demonstrating that preoperative patient optimization decreases risk of PJI. The goal of this study was to evaluate whether extended oral antibiotic prophylaxis reduces the one-year infection rate in high-risk patients. METHODS A total of 3855 consecutive primary THAs and TKAs performed between 2011 and 2019 at a suburban academic hospital with modern perioperative and infection-prevention protocols were retrospectively reviewed. Beginning in January 2015, a 7-day oral antibiotic prophylaxis protocol was implemented after discharge for patients at high risk for PJI. The percentage of high-risk patients diagnosed with PJI within 1 year was compared between groups that did and did not receive extended antibiotic prophylaxis. Univariate and logistic regression analyses were performed, with P ≤ .05 denoting statistical significance. RESULTS Overall 1-year infection rates were 2.26% and 0.85% after THA and TKA, respectively. High-risk patients with extended antibiotic prophylaxis had a significantly lower rate of PJI than high-risk patients without extended antibiotic prophylaxis (0.89% vs 2.64%, respectively; P < .001). There was no difference in the infection rate between high-risk patients who received antibiotics and low-risk patients (0.89% vs 1.29%, respectively; P = .348) with numbers available. CONCLUSION Extended postoperative oral antibiotic prophylaxis for 7 days led to a statistically significant and clinically meaningful reduction in 1-year infection rates of patients at high risk for infection. In fact, the PJI rate in high-risk patients who received antibiotics was less than the rate seen in low-risk patients. Thus, extended oral antibiotic prophylaxis may be a simple measure to effectively counteract poor host factors. Moreover, the findings of this study may mitigate the incentive to select healthier patients in outcome-based reimbursement models. Further study with a multicenter randomized control trial is needed to further validate this protocol. LEVEL OF EVIDENCE Therapeutic level III.
Collapse
Affiliation(s)
- Michael M. Kheir
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Julian E. Dilley
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN
| | | | - R. Michael Meneghini
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN,Indiana University Health Saxony Hip & Knee Center, Fishers, IN,Address correspondence to: R. Michael Meneghini, MD, Department of Orthopaedic Surgery, Indiana University Health Physicians Orthopedics and Sports Medicine, Indiana University School of Medicine, 13100 East 136th Street, Suite 2000, Fishers, IN 46037
| |
Collapse
|
7
|
Vidallon MLP, Teo BM. Recent developments in biomolecule-based nanoencapsulation systems for antimicrobial delivery and biofilm disruption. Chem Commun (Camb) 2021; 56:13907-13917. [PMID: 33146161 DOI: 10.1039/d0cc05880g] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Biomolecules are very attractive nanomaterial components, generally, due to their biocompatibility, biodegradability, abundance, renewability, and sustainability, as compared to other resources for nanoparticle-based delivery systems. Biomolecule-based nanoencapsulation and nanodelivery systems can be designed and engineered for antimicrobial cargos in order to surmount classical and current challenges, including the emergence of multi-drug resistant strains of microorganisms, the low effectiveness and limitations in the applicability of the present antimicrobials, and biofilm formation. This feature article highlights the recent applications and capabilities of biomacromolecule-based nanomaterials for the delivery and activity enhancement of antimicrobials, and disruption of biofilms. Unique properties of some nanomaterials, arising from specific biomacromolecules, were also emphasized. We expect that this review will be helpful to researchers in engineering new types of antimicrobial nanocarriers, hybrid particles and colloidal systems with tailored properties.
Collapse
Affiliation(s)
- Mark Louis P Vidallon
- School of Chemistry, Faculty of Science, Monash University, Clayton, VIC 3800, Australia.
| | - Boon Mian Teo
- School of Chemistry, Faculty of Science, Monash University, Clayton, VIC 3800, Australia.
| |
Collapse
|
8
|
Karthik CS, Chethana MH, Manukumar HM, Ananda AP, Sandeep S, Nagashree S, Mallesha L, Mallu P, Jayanth HS, Dayananda BP. Synthesis and characterization of chitosan silver nanoparticle decorated with benzodioxane coupled piperazine as an effective anti-biofilm agent against MRSA: A validation of molecular docking and dynamics. Int J Biol Macromol 2021; 181:540-551. [PMID: 33766592 DOI: 10.1016/j.ijbiomac.2021.03.119] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/19/2021] [Accepted: 03/21/2021] [Indexed: 12/11/2022]
Abstract
Biomaterial research has improved the delivery and efficacy of drugs over a wide range of pharmaceutical applications. The objective of this study was to synthesize benzodioxane coupled piperazine decorated chitosan silver nanoparticle (Bcp*C@AgNPs) against methicillin-resistant Staphylococcus aureus (MRSA) and to assess the nanoparticle as an effective candidate for antibacterial and anti-biofilm care. Antibacterial activity of the compound was examined and minimum inhibitory concentration (MIC) was observed at (10.21 ± 0.03 ZOI) a concentration of 200 μg/mL. The Bcp*C@AgNPs interferes with surface adherence of MRSA, suggesting an anti-biofilm distinctive property that is verified for the first time by confocal laser microscopic studies. By ADMET studies the absorption, distribution, metabolism, excretion and toxicity of the compound was examined. The interaction solidity and the stability of the compound when surrounded by water molecules were analyzed by docking and dynamic simulation analysis. The myoblast cell line (L6) was considered for toxicity study and was observed that the compound exhibited less toxic effect. This current research highlights the biocidal efficiency of Bcp*C@AgNPs with their bactericidal and anti-biofilm properties over potential interesting clinical trial targets in future.
Collapse
Affiliation(s)
- C S Karthik
- Department of Chemistry, SJCE, JSS Science and Technology University, Mysuru 570 006, Karnataka, India
| | - M H Chethana
- Department of Chemistry, SJCE, JSS Science and Technology University, Mysuru 570 006, Karnataka, India
| | - H M Manukumar
- Department of Chemistry, SJCE, JSS Science and Technology University, Mysuru 570 006, Karnataka, India
| | - A P Ananda
- Ganesh Consultancy and Analytical Services, Hebbal Industrial Area, Mysuru 570016, Karnataka, India
| | - S Sandeep
- Department of Chemistry, SJCE, JSS Science and Technology University, Mysuru 570 006, Karnataka, India
| | - S Nagashree
- Department of Chemistry, SJCE, JSS Science and Technology University, Mysuru 570 006, Karnataka, India
| | - L Mallesha
- PG Department of Chemistry, JSS College of Arts, Commerce and Science, Mysuru 570 025, Karnataka, India
| | - P Mallu
- Department of Chemistry, SJCE, JSS Science and Technology University, Mysuru 570 006, Karnataka, India.
| | - H S Jayanth
- Department of Microbiology, Yuvaraja's College, University of Mysore, Mysuru 570005, Karnataka, India
| | - B P Dayananda
- PG Department of Chemistry, Maharani's College, University of Mysore, Mysuru 570005, Karnataka, India
| |
Collapse
|
9
|
Quinn J, McFadden R, Chan CW, Carson L. Titanium for Orthopedic Applications: An Overview of Surface Modification to Improve Biocompatibility and Prevent Bacterial Biofilm Formation. iScience 2020; 23:101745. [PMID: 33235984 PMCID: PMC7670191 DOI: 10.1016/j.isci.2020.101745] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Titanium and its alloys have emerged as excellent candidates for use as orthopedic biomaterials. Nevertheless, there are often complications arising after implantation of orthopedic devices, most notably prosthetic joint infection and aseptic loosening. To ensure that implanted devices remain functional in situ, innovation in surface modification has attracted much attention in the effort to develop orthopedic materials with optimal characteristics at the biomaterial-tissue interface. This review will draw together metallurgy, surface engineering, biofilm microbiology, and biomaterial science. It will serve to appreciate why titanium and its alloys are frequently used orthopedic biomaterials and address some of the challenges facing these biomaterials currently, including the significant problem of device-associated infection. Finally, the authors shall consolidate and evaluate surface modification techniques employed to overcome some of these issues by offering a unique perspective as to the direction in which research is headed from a broad, interdisciplinary point of view.
Collapse
Affiliation(s)
- James Quinn
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Ryan McFadden
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Road, Belfast BT9 5AH, UK
| | - Chi-Wai Chan
- School of Mechanical and Aerospace Engineering, Queen's University Belfast, Ashby Building, Stranmillis Road, Belfast BT9 5AH, UK
| | - Louise Carson
- School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast BT9 7BL, UK
| |
Collapse
|
10
|
Calanna F, Chen F, Risitano S, Vorhies JS, Franceschini M, Giori NJ, Indelli PF. Debridement, antibiotic pearls, and retention of the implant (DAPRI): A modified technique for implant retention in total knee arthroplasty PJI treatment. J Orthop Surg (Hong Kong) 2020; 27:2309499019874413. [PMID: 31554470 DOI: 10.1177/2309499019874413] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
We describe a modified surgical technique developed to enhance the classical irrigation and debridement procedure to improve the possibilities of retaining an infected total knee arthroplasty. This technique, debridement antibiotic pearls and retention of the implant (DAPRI), aims to remove the intra-articular biofilm allowing a higher and prolonged local antibiotic concentration using calcium sulfate beads. The combination of three different surgical techniques (methylene blue staining, argon beam electrical stimulation, and chlorhexidine gluconate brushing) might enhance the identification, disruption, and finally removal of the bacterial biofilm, which is the main responsible of antibiotics and antibodies resistance. The DAPRI technique might represent a safe and more conservative treatment for acute and early hematogenous periprosthetic joint infection.
Collapse
Affiliation(s)
- Filippo Calanna
- Istituto Ortopedico Gaetano Pini, Division of Orthopaedic Surgery, Milan, Italy
| | - Foster Chen
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - Salvatore Risitano
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | - John S Vorhies
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | | | - Nicholas J Giori
- Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA
| | | |
Collapse
|
11
|
Yassin M, Sharma V, Butt F, Iyer S, Tayton E. Early Peri-Prosthetic Joint Infection after Hemiarthroplasty for Hip Fracture: Outcomes of Debridement, Antibiotics, and Implant Retention. Surg Infect (Larchmt) 2020; 21:834-839. [PMID: 32191561 DOI: 10.1089/sur.2019.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: There are currently no treatment algorithms specifically for early peri-prosthetic joint infection (PJI) after hemiarthroplasty for hip fracture. Commonly, debridement, antibiotics, and implant retention (DAIR) is attempted as first-line management, despite lack of evidence supporting this strategy in this patient group. The purpose of this study was to evaluate outcomes of DAIR for early PJI after hemiarthroplasty for hip fracture in our unit. Methods: The departmental database from December 2008 to January 2019 was searched to identify all patients in our unit who were treated for early PJI after hemiarthroplasty for hip fracture. Data for included patients were collected from electronic healthcare records and analyzed. Primary outcome measure was treatment success, defined as patient survival to discharge, with eradication of infection and implant retention. Results: Twenty-six patients were identified and included in the study. Mean age was 84.7 years. All except one patient were American Society of Anesthesiologists (ASA) class 3 or 4. All patients were McPherson host grade B or C. Twenty-three of 26 patients underwent DAIR and three of 26 proceeded directly to excision arthroplasty. Debridement, antibiotics, and implant retention was successful in three of 23 patients (13%) after a single procedure, with success in two additional patients after a second procedure, giving overall success rate of five of 23 patients (22%). Conclusions: Debridement, antibiotics, and implant retention has a high failure rate in treating early PJI after hemiarthroplasty for hip fracture. These patients are generally elderly and frail with multiple host and wound compromising factors. Debridement, antibiotics, and implant retention should not be recommended as first-line management for the majority of these patients, for whom getting it right the first time is of vital importance to avoid consequences associated with failed surgical procedures. Further multicenter studies that also explore alternate treatment strategies are required to devise an algorithm specifically for hip fracture patients, to aid decisions on treatment and improve outcomes.
Collapse
Affiliation(s)
- Mohamed Yassin
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, United Kingdom
| | - Vishnu Sharma
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, United Kingdom
| | - Faisal Butt
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, United Kingdom
| | - Shabnam Iyer
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, United Kingdom
| | - Edward Tayton
- Department of Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, United Kingdom
| |
Collapse
|
12
|
Ratka C, Weigl P, Henrich D, Koch F, Schlee M, Zipprich H. The Effect of In Vitro Electrolytic Cleaning on Biofilm-Contaminated Implant Surfaces. J Clin Med 2019; 8:jcm8091397. [PMID: 31500093 PMCID: PMC6780638 DOI: 10.3390/jcm8091397] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 11/20/2022] Open
Abstract
Purpose: Bacterial biofilms are a major problem in the treatment of infected dental and orthopedic implants. The purpose of this study is to investigate the cleaning effect of an electrolytic approach (EC) compared to a powder-spray system (PSS) on titanium surfaces. Materials and Methods: The tested implants (different surfaces and alloys) were collated into six groups and treated ether with EC or PSS. After a mature biofilm was established, the implants were treated, immersed in a nutritional solution, and streaked on Columbia agar. Colony-forming units (CFUs) were counted after breeding and testing (EC), and control (PSS) groups were compared using a paired sample t-test. Results: No bacterial growth was observed in the EC groups. After thinning to 1:1,000,000, 258.1 ± 19.9 (group 2), 264.4 ± 36.5 (group 4), and 245.3 ± 40.7 (group 6) CFUs could be counted in the PSS groups. The difference between the electrolytic approach (test groups 1, 3, and 5) and PSS (control groups 2, 4, and 6) was statistically extremely significant (p-value < 2.2 × 10−16). Conclusion: Only EC inactivated the bacterial biofilm, and PSS left reproducible bacteria behind. Within the limits of this in vitro test, clinical relevance could be demonstrated.
Collapse
Affiliation(s)
- Christoph Ratka
- Department of Prosthodontics, Goethe University, 60590 Frankfurt am Main, Germany.
| | - Paul Weigl
- Department of Prosthodontics, Goethe University, 60590 Frankfurt am Main, Germany.
| | - Dirk Henrich
- Department of Trauma, Hand & Reconstructive Surgery, Goethe University, 60590 Frankfurt am Main, Germany.
| | - Felix Koch
- Private Practice, and Department of Maxillofacial Surgery, Goethe University, 60590 Frankfurt am Main, Germany.
| | - Markus Schlee
- Private Practice, and Department of Maxillofacial Surgery, Goethe University, 60590 Frankfurt am Main, Germany.
| | - Holger Zipprich
- Department of Prosthodontics, Goethe University, 60590 Frankfurt am Main, Germany.
| |
Collapse
|
13
|
Ellington K, Bemenderfer TB. What Are the Indications for One-Stage Versus Two-Stage Exchange Arthroplasty in Management of the Infected Total Ankle Arthroplasty (TAA)? Foot Ankle Int 2019; 40:55S-58S. [PMID: 31322956 DOI: 10.1177/1071100719861104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
RECOMMENDATION Two-stage exchange arthroplasty is recommended in the majority of cases following infected TAA. One-stage arthroplasty is only indicated in a limited patient population with acute infection, preoperatively identified low-virulence organisms, and low-risk patient factors. LEVEL OF EVIDENCE Consensus. DELEGATE VOTE Agree: 92%, Disagree: 8%, Abstain: 0% (Super Majority, Strong Consensus).
Collapse
Affiliation(s)
- Kent Ellington
- 1 OrthoCarolina, Foot and Ankle Institute, Charlotte, NC, USA
| | | |
Collapse
|
14
|
Ellington K, Hirose CB, Bemenderfer TB. What Is the Treatment "Algorithm" for Infection After Ankle or Hindfoot Arthrodesis? Foot Ankle Int 2019; 40:64S-70S. [PMID: 31322955 DOI: 10.1177/1071100719861643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
RECOMMENDATION There is no universal algorithm for addressing the infected ankle or subtalar arthrodesis. A potential algorithm created by consensus is. LEVEL OF EVIDENCE Consensus. DELEGATE VOTE Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).
Collapse
Affiliation(s)
- Kent Ellington
- 1 OrthoCarolina, Foot and Ankle Institute, AtriumHealth, Charlotte, NC, USA
| | | | | |
Collapse
|
15
|
Feng R, Xu M, Li J, Huang S, Zhao G, Tu X, Sun G, Guo J. Structure and predictive functional profiling of microbial communities in two biotrickling filters treated with continuous/discontinuous waste gases. AMB Express 2019; 9:2. [PMID: 30610394 PMCID: PMC6320331 DOI: 10.1186/s13568-018-0726-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 12/24/2018] [Indexed: 01/06/2023] Open
Abstract
Two biotrickling filters were operated in continuous (BTF1) and discontinuous (BTF2) modes at a constant empty bed residence time of 60 s for 60 days. From day 60, the operation mode of each BTF was oppositely switched. Higher removal efficiencies of five aromatic pollutants were recorded with BTF1 (> 77.2%). The switch in the operation mode did not alter the removal performance of BTF1. Comparatively, BTF2 was not successfully acclimated in the discontinuous operation mode. Once the mode had been switched to continuous mode, the removal efficiencies of BTF2 on all pollutants increased drastically and finally exceeded the values observed in BTF1, with the single exception of p-xylene. Principle coordinate analysis and analysis of similarities (ANOSIM) showed that the structure of the microbial communities differed considerably between both BTFs (R = 1.000, p < 0.01) as well as before and after the switch in BTF2 (R = 0.996, p < 0.01). The random forest model demonstrated that Mycobacterium, Burkholderia, and Comamonas were the three most important bacterial genera contributing to the differences in microbial communities between the two BTFs. Metagenomics inferred by PICUSt (phylogenetic investigation of communities by reconstruction of unobserved states) indicated that BTF2 had high degradation potential for aromatic pollutants, although those genes involved in biofilm formation were less active in BTF2 than those in BTF1.
Collapse
|
16
|
Cox SC, Jamshidi P, Eisenstein NM, Webber MA, Burton H, Moakes RJA, Addison O, Attallah M, Shepherd DE, Grover LM. Surface Finish has a Critical Influence on Biofilm Formation and Mammalian Cell Attachment to Additively Manufactured Prosthetics. ACS Biomater Sci Eng 2017; 3:1616-1626. [DOI: 10.1021/acsbiomaterials.7b00336] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
| | | | - Neil M. Eisenstein
- Royal Centre for Defence Medicine, Birmingham Research Park, Vincent Drive, Edgbaston B15 2SQ, United Kingdom
| | - Mark A. Webber
- Institute of Food Research, Norwich
Research Park, Norwich NR4 7UG, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
17
|
Metsemakers WJ, Smeets B, Nijs S, Hoekstra H. Infection after fracture fixation of the tibia: Analysis of healthcare utilization and related costs. Injury 2017; 48:1204-1210. [PMID: 28377260 DOI: 10.1016/j.injury.2017.03.030] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 03/21/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION One of the most challenging complications in musculoskeletal trauma surgery is the development of infection after fracture fixation (IAFF). It can delay healing, lead to permanent functional loss, or even amputation of the affected limb. The main goal of this study was to investigate the total healthcare costs and length-of-stay (LOS) related to the surgical treatment of tibia fractures and furthermore identify the subset of clinical variables driving these costs within the Belgian healthcare system. The hypothesis was that deep infection would be the most important driver for total healthcare costs. PATIENTS AND METHODS Overall, 358 patients treated operatively for AO/OTA type 41, 42, and 43 tibia fractures between January 1, 2009 and January 1, 2014 were included in this study. A total of 26 clinical and process variables were defined. Calculated costs were limited to hospital care covered by the Belgian healthcare financing system. The five main cost categories studied were: honoraria, materials, hospitalization, day care admission, and pharmaceuticals. RESULTS Multivariate analysis showed that deep infection was the most significant characteristic driving total healthcare costs and LOS related to the surgical treatment of tibia fractures. Furthermore, this complication resulted in the highest overall increase in total healthcare costs and LOS. Treatment costs were approximately 6.5-times higher compared to uninfected patients. CONCLUSION This study shows the enormous hospital-related healthcare costs associated with IAFF of the tibia. Treatment costs for patients with deep infection are higher than previously mentioned in the literature. Therefore, future research should focus more on prevention rather than treatment strategies, not only to reduce patient morbidity but also to reduce the socio-economic impact.
Collapse
Affiliation(s)
- Willem-Jan Metsemakers
- University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven, University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium.
| | - Bart Smeets
- University Hospitals Leuven, Care Program Management, B-3000 Leuven, Belgium
| | - Stefaan Nijs
- University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven, University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium
| | - Harm Hoekstra
- University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium; KU Leuven, University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium
| |
Collapse
|
18
|
Dibartola AC, Swearingen MC, Granger JF, Stoodley P, Dusane DH. Biofilms in orthopedic infections: a review of laboratory methods. APMIS 2017; 125:418-428. [DOI: 10.1111/apm.12671] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 01/06/2016] [Indexed: 12/18/2022]
Affiliation(s)
| | - Matthew C. Swearingen
- Department of Microbial Infection and Immunity; The Ohio State University; Columbus OH USA
| | | | - Paul Stoodley
- Department of Microbial Infection and Immunity; The Ohio State University; Columbus OH USA
- Department of Orthopaedics; The Ohio State University; Columbus OH USA
- National Centre for Advanced Tribology; Faculty of Engineering and the Environment; University of Southampton; Southampton UK
| | - Devendra H. Dusane
- Department of Microbial Infection and Immunity; The Ohio State University; Columbus OH USA
| |
Collapse
|
19
|
Shi SF, Jia JF, Guo XK, Zhao YP, Chen DS, Guo YY, Zhang XL. Reduced Staphylococcus aureus biofilm formation in the presence of chitosan-coated iron oxide nanoparticles. Int J Nanomedicine 2016; 11:6499-6506. [PMID: 27994455 PMCID: PMC5153269 DOI: 10.2147/ijn.s41371] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Staphylococcus aureus can adhere to most foreign materials and form biofilm on the surface of medical devices. Biofilm infections are difficult to resolve. The goal of this in vitro study was to explore the use of chitosan-coated nanoparticles to prevent biofilm formation. For this purpose, S. aureus was seeded in 96-well plates to incubate with chitosan-coated iron oxide nanoparticles in order to study the efficiency of biofilm formation inhibition. The biofilm bacteria count was determined using the spread plate method; biomass formation was measured using the crystal violet staining method. Confocal laser scanning microscopy and scanning electron microscopy were used to study the biofilm formation. The results showed decreased viable bacteria numbers and biomass formation when incubated with chitosan-coated iron oxide nanoparticles at all test concentrations. Confocal laser scanning microscopy showed increased dead bacteria and thinner biofilm when incubated with nanoparticles at a concentration of 500 µg/mL. Scanning electron microscopy revealed that chitosan-coated iron oxide nanoparticles inhibited biofilm formation in polystyrene plates. Future studies should be performed to study these nanoparticles for anti-infective use.
Collapse
Affiliation(s)
- Si-Feng Shi
- Department of Orthopedics, the Affiliated Hospital of Xu Zhou Medical University, Xu Zhou, Jiangsu; Department of Orthopedic Surgery, Shanghai sixth People's Hospital, Shanghai Jiao Tong University, Shanghai
| | - Jing-Fu Jia
- School of Chemistry and Chemical Technology, Shanghai Jiao Tong University, Shanghai
| | - Xiao-Kui Guo
- Department of Medical Microbiology and Parasitology, Institutes of Medical Sciences, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Ya-Ping Zhao
- School of Chemistry and Chemical Technology, Shanghai Jiao Tong University, Shanghai
| | - De-Sheng Chen
- Department of Orthopedic Surgery, Shanghai sixth People's Hospital, Shanghai Jiao Tong University, Shanghai
| | - Yong-Yuan Guo
- Department of Orthopedic Surgery, Shanghai sixth People's Hospital, Shanghai Jiao Tong University, Shanghai
| | - Xian-Long Zhang
- Department of Orthopedic Surgery, Shanghai sixth People's Hospital, Shanghai Jiao Tong University, Shanghai
| |
Collapse
|
20
|
Walker TJ, Toriumi DM. Analysis of Facial Implants for Bacterial Biofilm Formation Using Scanning Electron Microscopy. JAMA FACIAL PLAST SU 2016; 18:299-304. [DOI: 10.1001/jamafacial.2016.0279] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Thomas J. Walker
- Department of Otolaryngology–Head and Neck Surgery, University of Illinois at Chicago
- currently in private practice, Atlanta, Georgia
| | - Dean M. Toriumi
- Department of Otolaryngology–Head and Neck Surgery, University of Illinois at Chicago
| |
Collapse
|
21
|
Influence of implant properties and local delivery systems on the outcome in operative fracture care. Injury 2016; 47:595-604. [PMID: 26847958 DOI: 10.1016/j.injury.2016.01.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 01/15/2016] [Indexed: 02/02/2023]
Abstract
Fracture fixation devices are implanted into a growing number of patients each year. This may be attributed to an increase in the popularity of operative fracture care and the development of ever more sophisticated implants, which may be used in even the most difficult clinical cases. Furthermore, as the general population ages, fragility fractures become more frequent. With the increase in number of surgical interventions, the absolute number of complications of these surgical treatments will inevitably rise. Implant-related infection and compromised fracture healing remain the most challenging and prevalent complications in operative fracture care. Any strategy that can help to reduce these complications will not only lead to a faster and more complete resumption of activities, but will also help to reduce the socio-economic impact. In this review we describe the influence of implant design and material choice on complication rates in trauma patients. Furthermore, we discuss the importance of local delivery systems, such as implant coatings and bone cement, and how these systems may have an impact on the prevalence, prevention and treatment outcome of these complications.
Collapse
|
22
|
Abstract
OBJECTIVES The purpose of this article was to present results of cases using a subcutaneous bone pouch technique and to assess the potential "autosterilization" effect that occurs when these contaminated free bone fragments are placed in nontraumatized tissue. DESIGN Retrospective review of prospectively collected data. SETTING Community-Based Level 1 Trauma Center. PATIENTS/PARTICIPANTS Eight patients were consented for the described technique, and data were collected over an 8-year period. INTERVENTION Placement of fragments into a surgically created subcutaneous pouch in a nontraumatized tissue zone, followed by delayed, cultured, and attempted reimplantation at the initial injury site. MAIN OUTCOME MEASUREMENTS Culture results after extraction of bone fragments from subcutaneous bone pouch and clinical outcomes after reimplantation into initial open fracture site. RESULTS All 8 cases undergoing this technique resulted in healing of the subcutaneous bone pouch without signs or symptoms of infection at the time of attempted reimplantation or fragment removal. Four of the 8 cases had successful reimplantation and union at the open fracture site. CONCLUSIONS Preserving devascularized bone fragments in a subcutaneous pouch in a region of nontraumatized tissue appears to be a safe procedure that allows for an "autosterilization" type of process to occur. LEVEL OF EVIDENCE Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Collapse
|
23
|
Cancienne JM, Burrus MT, Weiss DB, Yarboro SR. Applications of Local Antibiotics in Orthopedic Trauma. Orthop Clin North Am 2015; 46:495-510. [PMID: 26410638 DOI: 10.1016/j.ocl.2015.06.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Local antibiotics have a role in orthopedic trauma for both infection prophylaxis and treatment. They provide the advantage of high local antibiotic concentration without excessive systemic levels. Nonabsorbable polymethylmethacrylate (PMMA) is a popular antibiotic carrier, but absorbable options including bone graft, bone graft substitutes, and polymers have gained acceptance. Simple aqueous antibiotic solutions continue to be investigated and appear to be clinically effective. For established infections, such as osteomyelitis, a combination of surgical debridement with local and systemic antibiotics seems to represent the most effective treatment at this time. Further investigation of more effective local antibiotic utilization is ongoing.
Collapse
Affiliation(s)
- Jourdan M Cancienne
- Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Virginia Health System, PO Box 800159, Charlottesville, VA 22908-0159, USA
| | - M Tyrrell Burrus
- Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Virginia Health System, PO Box 800159, Charlottesville, VA 22908-0159, USA
| | - David B Weiss
- Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Virginia Health System, PO Box 800159, Charlottesville, VA 22908-0159, USA
| | - Seth R Yarboro
- Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, University of Virginia Health System, PO Box 800159, Charlottesville, VA 22908-0159, USA.
| |
Collapse
|
24
|
Zeng P, Li J, Liao D, Tu X, Xu M, Sun G. Performance of a combined system of biotrickling filter and photocatalytic reactor in treating waste gases from a paint-manufacturing plant. ENVIRONMENTAL TECHNOLOGY 2015; 37:237-244. [PMID: 26137915 DOI: 10.1080/09593330.2015.1068375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A pilot-scale biotrickling filter (BTF) was established in treating the waste gases that are intermittently produced from an automobile paint-manufacturing workshop. Results showed that the BTF required longer time to adapt to the aromatic compounds. The removal efficiencies (REs) for all aliphatic compounds reached more than 95% on day 80. Aromatic compounds were not easily removed by the BTF. The REs obtained by the BTF for toluene, ethylbenzene, m-xylene, o-xylene and p-xylene on day 80 were 72.7%, 77.2%, 71.9%, 74.8% and 60.0%, respectively. A maximum elimination capacity (EC) of 13.8 g-C m(-3) h(-1) of the BTF was achieved at an inlet loading rate of 19.4 g-C m(-3) h(-1) with an RE of 72%. Glucose addition promoted the biomass accumulation despite the fact that temporal decrease of REs for aromatic compounds occurred. When the inlet loading rates exceed 11.1 g-C m(-3) h(-1), the REs of the aromatic compounds decreased by 10% to 15%. This negative effect of shock loads on the performance of the BTF can be attenuated by the pre-treatment of the photocatalytic reactor. Nearly all components were removed by the combined system with REs of 99%.
Collapse
Affiliation(s)
- Peiyuan Zeng
- a Guangdong Institute of Microbiology , 100 Central Xianlie Road, Building 58, Guangzhou 510070 , People's Republic of China
- b Guangdong Open Laboratory of Applied Microbiology , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
- c State Key Laboratory of Applied Microbiology South China , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
| | - Jianjun Li
- a Guangdong Institute of Microbiology , 100 Central Xianlie Road, Building 58, Guangzhou 510070 , People's Republic of China
- b Guangdong Open Laboratory of Applied Microbiology , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
- c State Key Laboratory of Applied Microbiology South China , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
| | - Dongqi Liao
- a Guangdong Institute of Microbiology , 100 Central Xianlie Road, Building 58, Guangzhou 510070 , People's Republic of China
- b Guangdong Open Laboratory of Applied Microbiology , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
- c State Key Laboratory of Applied Microbiology South China , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
| | - Xiang Tu
- a Guangdong Institute of Microbiology , 100 Central Xianlie Road, Building 58, Guangzhou 510070 , People's Republic of China
- b Guangdong Open Laboratory of Applied Microbiology , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
- c State Key Laboratory of Applied Microbiology South China , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
| | - Meiying Xu
- a Guangdong Institute of Microbiology , 100 Central Xianlie Road, Building 58, Guangzhou 510070 , People's Republic of China
- b Guangdong Open Laboratory of Applied Microbiology , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
- c State Key Laboratory of Applied Microbiology South China , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
| | - Guoping Sun
- a Guangdong Institute of Microbiology , 100 Central Xianlie Road, Building 58, Guangzhou 510070 , People's Republic of China
- b Guangdong Open Laboratory of Applied Microbiology , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
- c State Key Laboratory of Applied Microbiology South China , 100 Central Xianlie Road, Guangzhou 510070 , People's Republic of China
| |
Collapse
|
25
|
Boraey MA, Guaily A, Epstein M. A hybrid model for biofilm growth on a deformable substratum. CAN J CHEM ENG 2015. [DOI: 10.1002/cjce.22172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
26
|
Connaughton A, Childs A, Dylewski S, Sabesan VJ. Biofilm Disrupting Technology for Orthopedic Implants: What's on the Horizon? Front Med (Lausanne) 2014; 1:22. [PMID: 25705632 PMCID: PMC4335381 DOI: 10.3389/fmed.2014.00022] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/29/2014] [Indexed: 11/29/2022] Open
Abstract
The use of orthopedic implants in joints has revolutionized the treatment of patients with many debilitating chronic musculoskeletal diseases such as osteoarthritis. However, the introduction of foreign material into the human body predisposes the body to infection. The treatment of these infections has become very complicated since the orthopedic implants serve as a surface for multiple species of bacteria to grow at a time into a resistant biofilm layer. This biofilm layer serves as a protectant for the bacterial colonies on the implant making them more resistant and difficult to eradicate when using standard antibiotic treatment. In some cases, the use of antibiotics alone has even made the bacteria more resistant to treatment. Thus, there has been surge in the creation of non-antibiotic anti-biofilm agents to help disrupt the biofilms on the orthopedic implants to help eliminate the infections. In this study, we discuss infections of orthopedic implants in the shoulder then we review the main categories of anti-biofilm agents that have been used for the treatment of infections on orthopedic implants. Then, we introduce some of the newer biofilm disrupting technology that has been studied in the past few years that may advance the treatment options for orthopedic implants in the future.
Collapse
Affiliation(s)
| | - Abby Childs
- Western Michigan University Homer Stryker MD School of Medicine , Kalamazoo, MI , USA
| | - Stefan Dylewski
- Michigan State University College of Human Medicine , Grand Rapids, MI , USA
| | - Vani J Sabesan
- Western Michigan University Homer Stryker MD School of Medicine , Kalamazoo, MI , USA
| |
Collapse
|