Pathogenesis and treatment concepts of orthopaedic biofilm infections.

Abstract

Implant-associated infection is caused by surface-adhering bacteria persisting as biofilm. Periprosthetic joint infection is difficult to diagnose and treat. The high susceptibility of implanted devices to infection is because of a locally acquired host defense defect, and persistence is mainly because of the rapid formation of a biofilm resistant to host defense and antimicrobial agents. Successful treatment of periprosthetic joint infection requires the optimal surgical procedure combined with long-term antimicrobial therapy directed against surface-adhering microorganisms. Surgical treatment according to an algorithm has been validated in several observational studies. The role of rifampin against device-associated staphylococcal infection has been evaluated in an animal model, in observational studies and in a controlled trial. Given the limited efficacy of traditional antibiotics in implant-associated infections, novel strategies such as coating of the device, vaccination against biofilms, and quorum-sensing inhibitors are promising future options for prevention and treatment.

• Authors: Werner Zimmerli, Claus Moser
• Journal: FEMS immunology and medical microbiology (FEMS Immunol Med Microbiol) Vol. 65 Issue 2 Pg. 158-68 (Jul 2012) ISSN: 1574-695X [Electronic] England
• PMID: 22309166 (Publication Type: Journal Article, Review)
• Copyright: © 2012 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Rifampin

Topics

• Animals
• Anti-Bacterial Agents (therapeutic use)
• Bacteria (pathogenicity)
• Bacterial Infections (drug therapy, microbiology, pathology, surgery)
• Bacterial Physiological Phenomena
• Biofilms (growth & development)
• Disease Models, Animal
• Humans
• Joint Prosthesis (microbiology)
• Prosthesis-Related Infections (drug therapy, microbiology, pathology, surgery)
• Randomized Controlled Trials as Topic
• Rifampin (therapeutic use)
• Treatment Outcome