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Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial

Background: Antibiotic management of low-virulent implant-associated infections induced by Cutibacterium acnes may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using...

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Autores principales: Tsikopoulos, Konstantinos, Drago, Lorenzo, Koutras, Georgios, Givissis, Panagiotis, Vagdatli, Eleni, Soukiouroglou, Prodromos, Papaioannidou, Paraskevi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285346/
https://www.ncbi.nlm.nih.gov/pubmed/32429267
http://dx.doi.org/10.3390/microorganisms8050743
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author Tsikopoulos, Konstantinos
Drago, Lorenzo
Koutras, Georgios
Givissis, Panagiotis
Vagdatli, Eleni
Soukiouroglou, Prodromos
Papaioannidou, Paraskevi
author_facet Tsikopoulos, Konstantinos
Drago, Lorenzo
Koutras, Georgios
Givissis, Panagiotis
Vagdatli, Eleni
Soukiouroglou, Prodromos
Papaioannidou, Paraskevi
author_sort Tsikopoulos, Konstantinos
collection PubMed
description Background: Antibiotic management of low-virulent implant-associated infections induced by Cutibacterium acnes may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using an in vitro model of infection. Methods: We used a total of 120 roughened titanium alloy disks, simulating orthopedic biomaterials, to assess the results of radial extracorporeal shock wave therapy (rESWT) against C. acnes (ATCC 11827) biofilms relative to untreated control. In particular, we considered 1.6 to 2.5 Bar with a frequency ranging from 8–11 Hz and 95 to 143 impulses per disk to investigate the antibacterial effect of rESWT against C. acnes planktonic (free-floating) and biofilm forms. Results: Planktonic bacteria load diminished by 54% compared to untreated control after a 1.8-bar setting with a frequency of 8 Hz and 95 impulses was applied (median absorbance (MA) for intervention vs. control groups was 0.9245 (IQR= 0.888 to 0.104) vs. 0.7705 (IQR = 0.712 to 0.864), respectively, p = 0.001). Likewise, a statistically significant reduction in the amount of biofilm relative to untreated control was documented when the above setting was considered (MA for treatment vs biofilm control groups was 0.244 (IQR= 0.215–0.282) and 0.298 (IQR = 0.247–0.307), respectively, p = 0.033). Conclusion: A 50% biofilm eradication was documented following application of low-pressure and low-frequency radial shock waves, so rESWT could be investigated as an adjuvant treatment to antibiotics, but it cannot be recommended as a standalone treatment against device-associated infections induced by C. ances.
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spelling pubmed-72853462020-06-17 Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial Tsikopoulos, Konstantinos Drago, Lorenzo Koutras, Georgios Givissis, Panagiotis Vagdatli, Eleni Soukiouroglou, Prodromos Papaioannidou, Paraskevi Microorganisms Article Background: Antibiotic management of low-virulent implant-associated infections induced by Cutibacterium acnes may be compromised by multi-drug resistance development, side effects, and increased cost. Therefore, we sought to assess the effects of shock wave therapy against the above pathogen using an in vitro model of infection. Methods: We used a total of 120 roughened titanium alloy disks, simulating orthopedic biomaterials, to assess the results of radial extracorporeal shock wave therapy (rESWT) against C. acnes (ATCC 11827) biofilms relative to untreated control. In particular, we considered 1.6 to 2.5 Bar with a frequency ranging from 8–11 Hz and 95 to 143 impulses per disk to investigate the antibacterial effect of rESWT against C. acnes planktonic (free-floating) and biofilm forms. Results: Planktonic bacteria load diminished by 54% compared to untreated control after a 1.8-bar setting with a frequency of 8 Hz and 95 impulses was applied (median absorbance (MA) for intervention vs. control groups was 0.9245 (IQR= 0.888 to 0.104) vs. 0.7705 (IQR = 0.712 to 0.864), respectively, p = 0.001). Likewise, a statistically significant reduction in the amount of biofilm relative to untreated control was documented when the above setting was considered (MA for treatment vs biofilm control groups was 0.244 (IQR= 0.215–0.282) and 0.298 (IQR = 0.247–0.307), respectively, p = 0.033). Conclusion: A 50% biofilm eradication was documented following application of low-pressure and low-frequency radial shock waves, so rESWT could be investigated as an adjuvant treatment to antibiotics, but it cannot be recommended as a standalone treatment against device-associated infections induced by C. ances. MDPI 2020-05-15 /pmc/articles/PMC7285346/ /pubmed/32429267 http://dx.doi.org/10.3390/microorganisms8050743 Text en © 2020 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tsikopoulos, Konstantinos
Drago, Lorenzo
Koutras, Georgios
Givissis, Panagiotis
Vagdatli, Eleni
Soukiouroglou, Prodromos
Papaioannidou, Paraskevi
Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial
title Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial
title_full Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial
title_fullStr Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial
title_full_unstemmed Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial
title_short Radial Extracorporeal Shock Wave Therapy against Cutibacterium acnes Implant-Associated Infections: An in Vitro Trial
title_sort radial extracorporeal shock wave therapy against cutibacterium acnes implant-associated infections: an in vitro trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285346/
https://www.ncbi.nlm.nih.gov/pubmed/32429267
http://dx.doi.org/10.3390/microorganisms8050743
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