The Journal of hospital infection · 2026
Polymicrobial infection requires higher concentration of irrigation solution than monomicrobial infection to eradicate biofilm grown on titanium surface: an in-vitro analysis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Semeshchenko Daniyil, Farinati Alicia, Huespe Iván, HIBA Hip Surgery Unit, Albani-Forneris Agustín F, Buttaro Martín A, Slullitel Pablo A, Meller Sebastian
Аннотация
BACKGROUND: Polymicrobial periprosthetic joint infection (PJI) is associated with poor outcomes after debridement, antibiotics, and implant retention (DAIR). Although irrigation is a critical component of DAIR, the concentrations required to eradicate polymicrobial biofilms remain unclear.
AIM: The aim of this study was to evaluate the in-vitro efficacy of four antiseptic irrigation solutions against monomicrobial and polymicrobial biofilms formed on clinically relevant titanium implant surfaces.
METHODS: Biofilms of methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans were grown on Ti-6Al-4V screw-hole covers. Povidone iodine (PI), acetic acid (AA), Granudacyn®, and chlorhexidine were tested. Minimal inhibitory, bactericidal, and biofilm eradication concentrations (minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBS), minimum biofilm eradication concentration [MBEC]) were determined. A 3-min irrigation assay assessed concentrations achieving ≥99.9% biofilm reduction in monomicrobial and polymicrobial models.
FINDINGS: PI demonstrated the greatest relative effectiveness in eradicating both monomicrobial and polymicrobial biofilms among the tested irrigation solutions. AA and chlorhexidine required substantially higher concentrations than their respective MBEC to achieve 99.9% biofilm eradication, whereas Granudacyn showed limited activity and failed to achieve complete eradication in either condition. Higher irrigation solution concentrations were consistently required to eradicate polymicrobial biofilms than monomicrobial biofilms across all agents. In particular, PI and AA required two- to four-fold higher concentrations, and chlorhexidine required approximately 10-fold higher concentrations, for polymicrobial biofilm eradication.
CONCLUSIONS: Polymicrobial biofilms demonstrate significantly increased tolerance to antiseptic irrigation compared with monomicrobial biofilms. Irrigation strategies effective against single-species infections may be inadequate in polymicrobial PJI, supporting the need for higher-concentration or optimized antiseptic protocols during DAIR.
AIM: The aim of this study was to evaluate the in-vitro efficacy of four antiseptic irrigation solutions against monomicrobial and polymicrobial biofilms formed on clinically relevant titanium implant surfaces.
METHODS: Biofilms of methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans were grown on Ti-6Al-4V screw-hole covers. Povidone iodine (PI), acetic acid (AA), Granudacyn®, and chlorhexidine were tested. Minimal inhibitory, bactericidal, and biofilm eradication concentrations (minimal inhibitory concentration (MIC), minimal bactericidal concentration (MBS), minimum biofilm eradication concentration [MBEC]) were determined. A 3-min irrigation assay assessed concentrations achieving ≥99.9% biofilm reduction in monomicrobial and polymicrobial models.
FINDINGS: PI demonstrated the greatest relative effectiveness in eradicating both monomicrobial and polymicrobial biofilms among the tested irrigation solutions. AA and chlorhexidine required substantially higher concentrations than their respective MBEC to achieve 99.9% biofilm eradication, whereas Granudacyn showed limited activity and failed to achieve complete eradication in either condition. Higher irrigation solution concentrations were consistently required to eradicate polymicrobial biofilms than monomicrobial biofilms across all agents. In particular, PI and AA required two- to four-fold higher concentrations, and chlorhexidine required approximately 10-fold higher concentrations, for polymicrobial biofilm eradication.
CONCLUSIONS: Polymicrobial biofilms demonstrate significantly increased tolerance to antiseptic irrigation compared with monomicrobial biofilms. Irrigation strategies effective against single-species infections may be inadequate in polymicrobial PJI, supporting the need for higher-concentration or optimized antiseptic protocols during DAIR.