Abstract
Hundreds of thousands of human implant procedures require surgical revision each year due to infection. Infections are difficult to treat with conventional antibiotics due to the formation of biofilm on the implant surface. We have developed a noninvasive method to eliminate biofilm on metal implants using heat generated by intermittent alternating magnetic fields (iAMF). Here, we demonstrate that heat and antibiotics are synergistic in biofilm elimination. For Pseudomonas aeruginosa biofilm, bacterial burden was reduced >3 log with iAMF and ciprofloxacin after 24 h compared with either treatment alone (p < 0.0001). This effect was not limited by pathogen or antibiotic as similar biofilm reductions were seen with iAMF and either linezolid or ceftriaxone in Staphylococcus aureus. iAMF and antibiotic efficacy was seen across various iAMF settings, including different iAMF target temperatures, dose durations, and dosing intervals. Initial mechanistic studies revealed membrane disruption as one factor important for AMF enhanced antibacterial activity in the biofilm setting. This study demonstrates the potential of utilizing a noninvasive approach to reduce biofilm off of metallic implants.
Highlights
Metal implants such as prosthetic joints, bone fixation hardware, and dental implants, are widely used in medicine to replace damaged or diseased tissue[1]
Studies conducted by our group and others have demonstrated a strong therapeutic effect of heat generated via alternating magnetic fields (AMF) and antibiotics on the eradication of biofilm[20,23,24]
A previous study by our group demonstrated that P. aeruginosa biofilm was more susceptible to ciprofloxacin after AMF treatment[22]
Summary
Metal implants such as prosthetic joints, bone fixation hardware, and dental implants, are widely used in medicine to replace damaged or diseased tissue[1]. This serious complication is challenging to treat[3]. The treatment of prosthetic joint infections (PJI) mainly relies on multiple revision surgeries. Initial surgery is performed to remove the infected implant and a temporary spacer is placed[4]. Once the patient is confirmed to be free of infection, a final surgery is performed to implant a new prosthesis[5]. Treatment of PJI is highly invasive with a significant negative impact on patients’ quality of life. The projected cost of treating PJI is 1.6 billion USD in 2020 in the United States alone, creating a significant economic burden to the health care system[8]
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