Advertisement for orthosearch.org.uk
Results 1 - 2 of 2
Results per page:
Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 91 - 91
1 Dec 2019
ANTIMICROBIAL PEPTIDES ERADICATE BACTERIA, INCLUDING PERSISTERS, IN ANTIBIOTIC-TREATED MATURE BIOFILMS
Scheper H Verhagen J de Visser A van der Wal R Wubbolts J Visser LG Boer MGJD Nibbering PH
Full Access
View article

Aims

Prosthetic joint infection (PJI) remains the most severe complication of arthroplasty. Failure of intensive, long-term antibiotic treatment for PJI often requires removal of the implant. Antibiotic failure is thought to be caused by biofilm and persister formation. Novel anti-biofilm and anti-persister strategies are urgently needed. Here, we investigated the effects of several antimicrobial peptides on the bacteria within antibiotic-treated biofilms in an in vitro mature biofilm model on abiotic surfaces.

Methods

On polystyrene, a mature (7 day-old) methicillin-resistant Staphylococcus aureus (MRSA) biofilm was developed. Thereafter, bacteria in the biofilm were exposed to rifampicin and ciprofloxacin (both 10× >MIC) for three days. Surviving bacteria in the antibiotic-treated biofilm, presumed to include persisters, were exposed to increasing doses of the antimicrobial peptides SAAP-148, acyldepsipeptide 4 (ADEP4), LL-37 and pexiganan. SAAP-148 was further tested on antibiotic-treated mature biofilms on titanium/aluminium/niobium (TAN) discs and prosthetic joint liners.

Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_14 | Pages 67 - 67
1 Dec 2019
THE PROSTHESIS PROTECT PROJECT: IMPROVING PATIENT CARE BY IMPLEMENTING A REGIONAL PROSPECTIVE QUALITY REGISTRY FOR PERIPROSTHETIC JOINT INFECTION
Scheper H van der Wal R Mahdad R Keizer S Delfos N van der Lugt J Veldkamp KE Hall ML van Elzakker E Boer MGJD Visser LG Nelissen R
Full Access
View article

Aims

Current antibiotic treatment strategies for prosthetic joint infection (PJI) are based mostly on observational retrospective studies. High-quality data from prospective cohorts using identical treatment strategies may improve current clinical practice. We developed a regional network of collaborating hospitals and established a uniform treatment protocol. Data from all patients diagnosed with a PJI are prospectively registered in a an online database. With this quality registry we aim to study the outcome of antibiotic and surgical strategies while adhering to a pre-established treatment protocol.

Methods

A working group of orthopaedic surgeons, infectious disease specialists and microbiologists was established. The working group reached consensus on definition of PJI and a uniform treatment protocol, based on current guidelines and expert-based clinical experience. A website was built to communicate information to colleagues and patients (www.protheseinfectie.nl). In each participating hospital weekly multidisciplinary meetings were started to discuss all PJI cases. All patients are included in an online quality registry and followed for at least two years. We aim to enroll >600 patients with a knee or hip PJI. Research will focus on the duration of antibiotic treatment, antibiotic suppressive therapy and comparison of different oral antibiotic treatment strategies in relation to successful treatment outcomes.

Image linking to Orthomedia