Biofilm formation by bacteria isolated from retrieved failed prosthetic hip implants in an in vitro model of hip arthroplasty antibiotic prophylaxis

Michael Tunney, Nicholas Dunne, Gisli Einarsson, A. McDowell, A. Kerr, Sheila Patrick

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Bacterial infection primarily with Staphylococcus spp. and Propionibacterium acnes remains a significant complication following total hip replacement. In this in vitro study, we investigated the efficacy of gentamicin loading of bone cement and pre- and postoperative administration of cefuroxime in the prevention of biofilm formation by clinical isolates. High and low initial inocula, representative of the number of bacteria that may be present at the operative site as a result of overt infection and skin contamination, respectively, were used. When a high initial inoculum was used, gentamicin loading of the cement did not prevent biofilm formation by the 10 Staphylococcus spp. and the 10 P. acnes isolates tested. Similarly, the use of cefuroxime in the fluid phase with gentamicin-loaded cement did not prevent biofilm formation by four Staphylococcus spp. and four P. acnes isolates tested. However, when a low bacterial inoculum was used, a combination of both gentamicin-loaded cement and cefuroxime prevented biofilm formation by these eight isolates. Our results indicate that this antibiotic combination may protect against infection after intra-operative challenge with bacteria present in low numbers as a result of contamination from the skin but would not protect against bacteria present in high numbers as a result of overt infection of an existing implant.
Original languageEnglish
Pages (from-to)2-10
Number of pages9
JournalJournal of Orthopaedic Research
Volume25
Issue number1
DOIs
Publication statusPublished - Jan 2007

Bibliographical note

© 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:2–10, 2007

Keywords

  • biofilm
  • bone cement
  • gentamicin
  • staphylococcus epidermidis
  • staphylococcus aureus
  • propionibacterium acnes

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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