Abstract
Biofilms forming on the surface of biomaterials can cause intractable implant-related infections. Bacterial adherence and early biofilm formation are influenced by the type of biomaterial used and the physical characteristics of implant surface. In this in vitro research, we evaluated the ability of Staphylococcus epidermidis, the main pathogen in implant-related infections, to form biofilms on the surface of the solid orthopaedic biomaterials, oxidized zirconium-niobium alloy, cobalt-chromium-molybdenum alloy (Co-Cr-Mo), titanium alloy (Ti-6Al-4V), commercially pure titanium (cp-Ti) and stainless steel. A bacterial suspension of Staphylococcus epidermidis strain RP62A (ATCC35984) was added to the surface of specimens and incubated. The stained biofilms were imaged with a digital optical microscope and the biofilm coverage rate (BCR) was calculated. The total amount of biofilm was determined with the crystal violet assay and the number of viable cells in the biofilm was counted using the plate count method. The BCR of all the biomaterials rose in proportion to culture duration. After culturing for 2–4 hours, the BCR was similar for all materials. However, after culturing for 6 hours, the BCR for Co-Cr-Mo alloy was significantly lower than for Ti-6Al-4V, cp-Ti and stainless steel (P<0.05). The absorbance value determined in the crystal violet assay and the number of viable cells on Co-Cr-Mo were not significantly lower than for the other materials (P>0.05). These results suggest that surface properties, such as hydrophobicity or the low surface free energy of Co-Cr-Mo, may have some influence in inhibiting or delaying the two-dimensional expansion of biofilm on surfaces with a similar degree of smoothness.
Highlights
Solid biomaterials with particular characteristics, such as high biocompatibility or corrosion resistance, are being implanted in the human body more frequently for a wide range of purposes
The biofilm enveloping the bacteria can protect them from the immune system
We have discovered no previous research focusing on the biofilm formation ability of different biomaterials, including Oxidized Zirconium-Niobium alloy (Oxinium), which eliminates the influence of surface roughness
Summary
Solid biomaterials with particular characteristics, such as high biocompatibility or corrosion resistance, are being implanted in the human body more frequently for a wide range of purposes. Implant-related infection is generally the most common serious complication and the risk of surgical site infection (SSI) increases when a foreign material is present [1]. Various methods have been devised to prevent implant-related infections, including techniques to sterilize the surgical site and instruments, and the use of highly sterile operating rooms. These infections still occur today in 0.2–17.3% of orthopaedic surgery [10,11,12]. Research investigating the formation of biofilms on biomaterials is critically important from the clinical perspective
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