Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex Vivo
<b>Background/Objectives:</b> Periprosthetic joint infections (PJI) are difficult to treat due to biofilm formation on implant surfaces and the surrounding tissue, often requiring removal or exchange of prostheses along with long-lasting antibiotic treatment. Antiseptic irrigation during...
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MDPI AG
2025-01-01
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| author | Anja L. Honegger Tiziano A. Schweizer Yvonne Achermann Philipp P. Bosshard |
| author_facet | Anja L. Honegger Tiziano A. Schweizer Yvonne Achermann Philipp P. Bosshard |
| author_sort | Anja L. Honegger |
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| description | <b>Background/Objectives:</b> Periprosthetic joint infections (PJI) are difficult to treat due to biofilm formation on implant surfaces and the surrounding tissue, often requiring removal or exchange of prostheses along with long-lasting antibiotic treatment. Antiseptic irrigation during revision surgery might decrease bacterial biofilm load and thereby improve treatment success. This in vitro study investigated and compared the effect of five advanced wound irrigation solutions to reduce bacterial burden in the PJI microenvironment. <b>Methods:</b> We treated in vitro biofilms grown on titanium alloy implant discs with clinical bacterial strains isolated from patients with PJIs, as well as abscess communities in a plasma-supplemented collagen matrix. The biofilms were exposed for 1 min to the following wound irrigation solutions: Preventia<sup>®</sup>, Prontosan<sup>®</sup>, Granudacyn<sup>®</sup>, ActiMaris<sup>®</sup> forte (‘Actimaris’), and Octenilin<sup>®</sup>. We measured the bacterial reduction of these irrigation solutions compared to Ringer–Lactate and to the strong bactericidal but not approved Betaseptic solution. Additionally, ex vivo free-floating bacteria isolated directly from clinical sonication fluids were treated in the same way, and regrowth or lack of regrowth was recorded as the outcome. <b>Results:</b> Irrigation solutions demonstrated variable efficacy. The mean CFU log<sub>10</sub> reduction was as follows: Octenilin, 3.07, Preventia, 1.17, Actimaris, 1.11, Prontosan, 1.03, and Granudacyn, 0.61. For SACs, the reduction was: Actimaris, 8.27, Octenilin, 0.58, Prontosan, 0.56, Preventia, 0.35, and Granudacyn, 0.24. <b>Conclusions:</b> All solutions achieved complete bacterial eradication in all tested ex vivo sonication fluids, except Granudacyn, which was ineffective in 33% of the samples (2 out of 6). Advanced wound irrigation solutions have the potential to reduce bacterial burden in the PJI microenvironment during revision surgery. However, their efficacy varies depending on bacterial species, growth state, and the composition of the irrigation solution. This underscores the importance of considering these factors when developing future PJI-specific irrigation solutions. |
| format | Article |
| id | doaj-art-eef5cc5eae234bd78803bcb1e9508374 |
| institution | Kabale University |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj-art-eef5cc5eae234bd78803bcb1e95083742025-01-24T13:18:35ZengMDPI AGAntibiotics2079-63822025-01-011412510.3390/antibiotics14010025Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex VivoAnja L. Honegger0Tiziano A. Schweizer1Yvonne Achermann2Philipp P. Bosshard3Department of Dermatology, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Dermatology, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Dermatology, University Hospital Zurich, University of Zurich, 8091 Zurich, SwitzerlandDepartment of Dermatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland<b>Background/Objectives:</b> Periprosthetic joint infections (PJI) are difficult to treat due to biofilm formation on implant surfaces and the surrounding tissue, often requiring removal or exchange of prostheses along with long-lasting antibiotic treatment. Antiseptic irrigation during revision surgery might decrease bacterial biofilm load and thereby improve treatment success. This in vitro study investigated and compared the effect of five advanced wound irrigation solutions to reduce bacterial burden in the PJI microenvironment. <b>Methods:</b> We treated in vitro biofilms grown on titanium alloy implant discs with clinical bacterial strains isolated from patients with PJIs, as well as abscess communities in a plasma-supplemented collagen matrix. The biofilms were exposed for 1 min to the following wound irrigation solutions: Preventia<sup>®</sup>, Prontosan<sup>®</sup>, Granudacyn<sup>®</sup>, ActiMaris<sup>®</sup> forte (‘Actimaris’), and Octenilin<sup>®</sup>. We measured the bacterial reduction of these irrigation solutions compared to Ringer–Lactate and to the strong bactericidal but not approved Betaseptic solution. Additionally, ex vivo free-floating bacteria isolated directly from clinical sonication fluids were treated in the same way, and regrowth or lack of regrowth was recorded as the outcome. <b>Results:</b> Irrigation solutions demonstrated variable efficacy. The mean CFU log<sub>10</sub> reduction was as follows: Octenilin, 3.07, Preventia, 1.17, Actimaris, 1.11, Prontosan, 1.03, and Granudacyn, 0.61. For SACs, the reduction was: Actimaris, 8.27, Octenilin, 0.58, Prontosan, 0.56, Preventia, 0.35, and Granudacyn, 0.24. <b>Conclusions:</b> All solutions achieved complete bacterial eradication in all tested ex vivo sonication fluids, except Granudacyn, which was ineffective in 33% of the samples (2 out of 6). Advanced wound irrigation solutions have the potential to reduce bacterial burden in the PJI microenvironment during revision surgery. However, their efficacy varies depending on bacterial species, growth state, and the composition of the irrigation solution. This underscores the importance of considering these factors when developing future PJI-specific irrigation solutions.https://www.mdpi.com/2079-6382/14/1/25PJIbiofilmirrigationwound irrigation solution |
| spellingShingle | Anja L. Honegger Tiziano A. Schweizer Yvonne Achermann Philipp P. Bosshard Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex Vivo Antibiotics PJI biofilm irrigation wound irrigation solution |
| title | Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex Vivo |
| title_full | Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex Vivo |
| title_fullStr | Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex Vivo |
| title_full_unstemmed | Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex Vivo |
| title_short | Antimicrobial Efficacy of Five Wound Irrigation Solutions in the Periprosthetic Joint Infection Microenvironment In Vitro and Ex Vivo |
| title_sort | antimicrobial efficacy of five wound irrigation solutions in the periprosthetic joint infection microenvironment in vitro and ex vivo |
| topic | PJI biofilm irrigation wound irrigation solution |
| url | https://www.mdpi.com/2079-6382/14/1/25 |
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