Abstract
Our current challenge in the management of prosthetic joint infection is the eradication of biofilms which has driven the need for improved antimicrobial agents and regimens. In this study, the antimicrobial peptide, LL-37, and silver nanoparticles (AgNPs) were investigated for their antimicrobial efficacies against Staphylococcus aureus (S. aureus), a microorganism commonly implicated in biofilm-related infections. These antimicrobials were compared to conventional antibiotics and combination treatments with rifampin. Using a Centers for Disease Control reactor, 24 h S. aureus biofilms were formed on cobalt-chromium discs and the anti-biofilm activity was determined by quantifying the amount of colony forming units following treatments. We found that LL-37 was the most efficacious antimicrobial agent with a more than 4 log reduction in colony counts. In comparison, silver nanoparticles and conventional antibiotics were not as efficacious, with a less than 1 log reduction in colony counts. Antimicrobial combination treatments with rifampin significantly increased the log reduction for AgNPs and gentamicin, although still significantly less than LL-37 in isolation. Furthermore, kinetic studies revealed the rapid elimination of S. aureus biofilm with LL-37. Collectively, the results of this study demonstrated that LL-37 was an effective agent against S. aureus biofilms and may have potential clinical applications in the eradication of biofilms and treatment of prosthetic joint infection.
Highlights
Primary arthroplasty, such as total knee arthroplasty (TKA), is one of the most commonly performed orthopedic procedures
Treatment of 24 h S. aureus biofilms formed on cobalt chrome (Co-Cr) discs with LL-37, AgNPs, conventional antibiotics, and combination treatments with rifampin were investigated
We investigated the antimicrobial efficacy of LL-37 against S. aureus biofilms
Summary
Primary arthroplasty, such as total knee arthroplasty (TKA), is one of the most commonly performed orthopedic procedures. A small proportion of these patients will become infected, as between 0.5 to 2% of these procedures may result in prosthetic joint infection (PJI), an infection of the prosthesis, joint, and adjacent tissue [2,3,4,5,6]. This type of implant failure causes considerable morbidity and is associated with significant financial costs to the healthcare system. With an increasing number of primary arthroplasties being performed each year, we can expect the incidence of PJI and its associated burdens to rise as well
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