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Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials

Hydrogen peroxide, povidone-iodine, and chlorhexidine are antiseptics that are commonly added to irrigants to either prevent or treat infection. There are little clinical data available that demonstrate efficacy of adding antiseptics to irrigants in the treatment of periprosthetic joint infection af...

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Autores principales: Parker, Dana M., Koch, John A., Gish, Charles G., Brothers, Kimberly M., Li, William, Gilbertie, Jessica, Rowe, Sarah E., Conlon, Brian P., Byrapogu, Venkata K. C., Urish, Kenneth L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304975/
https://www.ncbi.nlm.nih.gov/pubmed/37374013
http://dx.doi.org/10.3390/life13061230
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author Parker, Dana M.
Koch, John A.
Gish, Charles G.
Brothers, Kimberly M.
Li, William
Gilbertie, Jessica
Rowe, Sarah E.
Conlon, Brian P.
Byrapogu, Venkata K. C.
Urish, Kenneth L.
author_facet Parker, Dana M.
Koch, John A.
Gish, Charles G.
Brothers, Kimberly M.
Li, William
Gilbertie, Jessica
Rowe, Sarah E.
Conlon, Brian P.
Byrapogu, Venkata K. C.
Urish, Kenneth L.
author_sort Parker, Dana M.
collection PubMed
description Hydrogen peroxide, povidone-iodine, and chlorhexidine are antiseptics that are commonly added to irrigants to either prevent or treat infection. There are little clinical data available that demonstrate efficacy of adding antiseptics to irrigants in the treatment of periprosthetic joint infection after biofilm establishment. The objective of the study was to assess the bactericidal activity of the antiseptics on S. aureus planktonic and biofilm. For planktonic irrigation, S. aureus was exposed to different concentrations of antiseptics. S. aureus biofilm was developed by submerging a Kirschner wire into normalized bacteria and allowing it to grow for forty-eight hours. The Kirschner wire was then treated with irrigation solutions and plated for CFU analysis. Hydrogen peroxide, povidone-iodine, and chlorhexidine were bactericidal against planktonic bacteria with over a 3 log reduction (p < 0.0001). Unlike cefazolin, the antiseptics were not bactericidal (less than 3 log reduction) against biofilm bacteria but did have a statistical reduction in biofilm as compared to the initial time point (p < 0.0001). As compared to cefazolin treatment alone, the addition of hydrogen peroxide or povidone-iodine to cefazolin treatment only additionally reduced the biofilm burden by less than 1 log. The antiseptics demonstrated bactericidal properties with planktonic S. aureus; however, when used to irrigate S. aureus biofilms, these antiseptics were unable to decrease biofilm mass below a 3 log reduction, suggesting that S. aureus biofilm has a tolerance to antiseptics. This information should be considered when considering antibiotic tolerance in established S. aureus biofilm treatment.
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spelling pubmed-103049752023-06-29 Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials Parker, Dana M. Koch, John A. Gish, Charles G. Brothers, Kimberly M. Li, William Gilbertie, Jessica Rowe, Sarah E. Conlon, Brian P. Byrapogu, Venkata K. C. Urish, Kenneth L. Life (Basel) Communication Hydrogen peroxide, povidone-iodine, and chlorhexidine are antiseptics that are commonly added to irrigants to either prevent or treat infection. There are little clinical data available that demonstrate efficacy of adding antiseptics to irrigants in the treatment of periprosthetic joint infection after biofilm establishment. The objective of the study was to assess the bactericidal activity of the antiseptics on S. aureus planktonic and biofilm. For planktonic irrigation, S. aureus was exposed to different concentrations of antiseptics. S. aureus biofilm was developed by submerging a Kirschner wire into normalized bacteria and allowing it to grow for forty-eight hours. The Kirschner wire was then treated with irrigation solutions and plated for CFU analysis. Hydrogen peroxide, povidone-iodine, and chlorhexidine were bactericidal against planktonic bacteria with over a 3 log reduction (p < 0.0001). Unlike cefazolin, the antiseptics were not bactericidal (less than 3 log reduction) against biofilm bacteria but did have a statistical reduction in biofilm as compared to the initial time point (p < 0.0001). As compared to cefazolin treatment alone, the addition of hydrogen peroxide or povidone-iodine to cefazolin treatment only additionally reduced the biofilm burden by less than 1 log. The antiseptics demonstrated bactericidal properties with planktonic S. aureus; however, when used to irrigate S. aureus biofilms, these antiseptics were unable to decrease biofilm mass below a 3 log reduction, suggesting that S. aureus biofilm has a tolerance to antiseptics. This information should be considered when considering antibiotic tolerance in established S. aureus biofilm treatment. MDPI 2023-05-23 /pmc/articles/PMC10304975/ /pubmed/37374013 http://dx.doi.org/10.3390/life13061230 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Communication
Parker, Dana M.
Koch, John A.
Gish, Charles G.
Brothers, Kimberly M.
Li, William
Gilbertie, Jessica
Rowe, Sarah E.
Conlon, Brian P.
Byrapogu, Venkata K. C.
Urish, Kenneth L.
Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials
title Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials
title_full Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials
title_fullStr Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials
title_full_unstemmed Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials
title_short Hydrogen Peroxide, Povidone-Iodine and Chlorhexidine Fail to Eradicate Staphylococcus aureus Biofilm from Infected Implant Materials
title_sort hydrogen peroxide, povidone-iodine and chlorhexidine fail to eradicate staphylococcus aureus biofilm from infected implant materials
topic Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10304975/
https://www.ncbi.nlm.nih.gov/pubmed/37374013
http://dx.doi.org/10.3390/life13061230
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