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Can the biofilm produced by Staphylococcus aureus on implant be eradicated by covered with bone cement? in vitro study

Introduction: Periprosthetic joint infections (PJI) are increasing as a result of increased major joint arthroplasty (MJA). Classical treatment of PJI is a two-stage revision. However, this approach results in morbidity and is not cost effective. We investigated whether covering of the implants with bone cement is sufficient for eradication of microorganism on biofilm.

Materials and Methods: 24 plates were infected by Methicillin-resistant S. aureus (MRSA) in tryptic soy broth (TSB) for biofilm formation for 48 h. They are divided into four groups. Biofilm and living bacteria were shown in first and second groups. Infected implants were covered with bone cement to show eradication of biofilm in third and fourth groups. After implants were covered with bone cement, the bone cement was broken 24 h later, in sterile conditions. Implants were evaluated in terms of bacteria colonies by using the dilutions method.

Results: The biofilm was shown in group I by using scanning electron microscopy (SEM). Bacteria colonies were very high in number in group II (3.1 ± 0.3. Mean cfu × 108 ± SEM). Bacteria colonies weren’t identified in groups III and IV (0 ± 0 Mean cfu × 108 ± SEM). There were statistical differences between the group II and group III-IV (P<0.05). There weren’t any statistical differences between groups III -IV (P>0.05).

Conclusion: This study shows that, Staphylococci biofilm formation on orthopaedic implants can be eradicated completely by covering the implants with bone cement. PJI may be treated by covered with bone cement without removed implants.

Author(s): Hasan Gocer, Dilek Emir, Mehmet Emin Onger