Open AccessPathogenesis and treatment concepts of orthopaedic biofilm infections
Author(s) -
Zimmerli Werner,
Moser Claus
Publication year - 2012
Publication title -
fems immunology & medical microbiology
Language(s) - English
Resource type - Journals
eISSN - 1574-695X
pISSN - 0928-8244
DOI - 10.1111/j.1574-695x.2012.00938.x
Subject(s) - biofilm , periprosthetic , antimicrobial , antibiotics , biology , vaccination , observational study , implant , microbiology and biotechnology , staphylococcal infections , medicine , immunology , arthroplasty , staphylococcus aureus , bacteria , surgery , genetics
Implant‐associated infection is caused by surface‐adhering bacteria persisting as biofilm. Periprosthetic joint infection is difficult to diagnose and treat. The high susceptibility of implanted devices to infection is because of a locally acquired host defense defect, and persistence is mainly because of the rapid formation of a biofilm resistant to host defense and antimicrobial agents. Successful treatment of periprosthetic joint infection requires the optimal surgical procedure combined with long‐term antimicrobial therapy directed against surface‐adhering microorganisms. Surgical treatment according to an algorithm has been validated in several observational studies. The role of rifampin against device‐associated staphylococcal infection has been evaluated in an animal model, in observational studies and in a controlled trial. Given the limited efficacy of traditional antibiotics in implant‐associated infections, novel strategies such as coating of the device, vaccination against biofilms, and quorum‐sensing inhibitors are promising future options for prevention and treatment.