Staphylococcus aureus Aggregates on Orthopedic Materials under Varying Levels of Shear Stress
Staphylococcus aureus Aggregates on Orthopedic Materials under Varying Levels of Shear Stress
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DOI：
10.1128/aem.01234-20
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发表时间：
2020-10-01
影响因子：
4.4
通讯作者：
Stoodley, Paul
中科院分区：
文献类型：
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作者：
Gupta, Tripti Thapa;Gupta, Niraj K.;Stoodley, Paul
人工关节置换术后发生的假体周围关节感染（PJI）是一个需要多次手术和抗生素干预的主要临床问题。金黄色葡萄球菌是PJI最常见的细菌。最近的体外研究表明，葡萄球菌菌株在滑液（SF）的存在下迅速形成聚集体。我们假设这些聚集体为进入伤口部位的细菌提供早期保护，使它们有时间附着在植入物表面，导致生物膜形成。因此，了解这些聚集体的附着动力学对于了解它们对各种生物材料表面的粘附至关重要。在这项研究中，数量，大小和表面积覆盖的聚集体以及单细胞的S。金黄色葡萄球菌在各种条件下在与骨科手术相关的不同骨科材料上进行定量：不锈钢（316 L）、钛（Ti）、羟基磷灰石（HA）和聚乙烯（PE）。据观察，无论材料类型，SF诱导的聚集导致减少聚集体表面附着和更大的聚集体大小比单细胞群体在各种剪切应力下。此外，与其他材料相比，PE上细菌聚集体的表面积覆盖率相对较高，这可能是由于PE的表面较粗糙。此外，增加剪切应力至78 mPa降低了聚集体对Ti和HA的附着，同时增加了聚集体的平均尺寸。因此，这项研究表明，SF诱导抑制聚集体附着到所有材料，这表明生物膜的形成是由种植体和宿主tissues.IMPORTANCE表面特征上的聚集体的住宿开始的人工关节置换术后发生的假体周围关节感染是一个重大的临床问题，需要反复手术和抗生素干预。不幸的是，26%的患者在发生这些感染后5年内死亡。金黄色葡萄球菌是最常见的细菌负责这个问题，可以形成生物膜，以提供保护，从抗生素以及免疫系统。虽然在受感染的植入物上有明显的生物膜，但目前还不清楚这些生物膜是如何附着在表面的。最近的体外研究表明，葡萄球菌菌株在滑液存在下迅速形成聚集体，并为细菌提供保护，从而使它们有时间附着在植入物表面，导致生物膜形成。在这项研究中，我们研究了不同骨科材料上的金黄色葡萄球菌聚集体的附着动力学。本文提供的信息将有助于外科治疗和种植体设计。
Periprosthetic joint infection (PJI) occurring after artificial joint replacement is a major clinical issue requiring multiple surgeries and antibiotic interventions. Staphylococcus aureus is the bacterium most commonly responsible for PJI. Recent in vitro research has shown that staphylococcal strains rapidly form aggregates in the presence of synovial fluid (SF). We hypothesize that these aggregates provide early protection to bacteria entering the wound site, allowing them time to attach to the implant surface, leading to biofilm formation. Thus, understanding the attachment kinetics of these aggregates is critical in understanding their adhesion to various biomaterial surfaces. In this study, the number, size, and surface area coverage of aggregates as well as of single cells of S. aureus were quantified under various conditions on different orthopedic materials relevant to orthopedic surgery: stainless steel (316L), titanium (Ti), hydroxyapatite (HA), and polyethylene (PE). It was observed that, regardless of the material type, SF-induced aggregation resulted in reduced aggregate surface attachment and greater aggregate size than the single-cell populations under various shear stresses. Additionally, the surface area coverage of bacterial aggregates on PE was relatively high compared to that on other materials, which could potentially be due to the rougher surface of PE. Furthermore, increasing shear stress to 78 mPa decreased aggregate attachment to Ti and HA while increasing the aggregates' average size. Therefore, this study demonstrates that SF induced inhibition of aggregate attachment to all materials, suggesting that biofilm formation is initiated by lodging of aggregates on the surface features of implants and host tissues.IMPORTANCE Periprosthetic joint infection occurring after artificial joint replacement is a major clinical issue that require repeated surgeries and antibiotic interventions. Unfortunately, 26% of patients die within 5 years of developing these infections. Staphylococcus aureus is the bacterium most commonly responsible for this problem and can form biofilms to provide protection from antibiotics as well as the immune system. Although biofilms are evident on the infected implants, it is unclear how these are attached to the surface in the first place. Recent in vitro investigations have shown that staphylococcal strains rapidly form aggregates in the presence of synovial fluid and provide protection to bacteria, thus allowing them time to attach to the implant surface, leading to biofilm formation. In this study, we investigated the attachment kinetics of Staphylococcus aureus aggregates on different orthopedic materials. The information presented in this article will be useful in surgical management and implant design.